The evaluation of IMA as a cardiac ischemia marker in the cases of hypohemoglobinemia and hypoxemia due to blood loss

Abstract

Objective: Although the mechanism is still not so clear, ischemia modified albumin is produced as a result of the occurrence of changes in metal binding regions on the albumin with the production of reactive oxygen species. But it is not known whether this change is the cause or the result of different states. This study is designed to investigate the correlation between hypohemoglobinemia, hypoxemia due to blood loss and IMA. Methods: The research is carried out with 83 patients (28 Male, 55 Female; mean age: 51±22 year) and 19 subject as control group (7Male, 12 Female; mean age 35±18 year). Patients were divided into three sub-groups according to their hemoglobin levels (<8, 8-10, 10-12 g/dL). Additionally, same patients were divided into second sub-group according to their follow-up status as outpatient (40 male, 15 female, mean age: 48 ± 20 year), postoperative (8 male, 11 female, mean age: 49 ± 24 year) and intensive care unit (6 male, 5 female; mean age: 64±20 year) patients. To determine the IMA levels the measurement method based on albumin cobalt binding assay was used. Results: In IMA levels, no significant difference is found between the mild (Hb: 10-12 g/dL) [(n=47; 0,61±0,23 ABSU)], moderate (Hb: 8-10 g/dL) [(n=26; 0.58±0.24 ABSU)] and severe (Hb: <8 g/dL) [(n=9; 0.62±0.12 ABSU)] anemia groups. However, because of acute blood loss related acute hypoxemia; IMA levels of the postoperative patients are statistically higher as compared to control group. As compared to control groups, no statistically significant difference is observed in the levels of the serum IMA in the outpatient group who had minimally invasive surgery and in the intensive care patient group. Conclusion: Our results suggest that; if mycardial oxygenization is questioned in cases of acute and heavy blood loss, ischemia modified albumin is not a valuable test for the indicator of the myocardial ischemia.