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ÖZBIÇER S, KALKAN G, URGUN ÖD, NEŞELİOĞLU S, EREL Ö. Ischemia modified albumin levels in distinguishing NSTEMI patients from non-ischemic controls and correlation with disease severity. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.976875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Physiology, pathophysiology and (mal)adaptations to chronic apnoeic training: a state-of-the-art review. Eur J Appl Physiol 2021; 121:1543-1566. [PMID: 33791844 PMCID: PMC8144079 DOI: 10.1007/s00421-021-04664-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
Breath-hold diving is an activity that humans have engaged in since antiquity to forage for resources, provide sustenance and to support military campaigns. In modern times, breath-hold diving continues to gain popularity and recognition as both a competitive and recreational sport. The continued progression of world records is somewhat remarkable, particularly given the extreme hypoxaemic and hypercapnic conditions, and hydrostatic pressures these athletes endure. However, there is abundant literature to suggest a large inter-individual variation in the apnoeic capabilities that is thus far not fully understood. In this review, we explore developments in apnoea physiology and delineate the traits and mechanisms that potentially underpin this variation. In addition, we sought to highlight the physiological (mal)adaptations associated with consistent breath-hold training. Breath-hold divers (BHDs) are evidenced to exhibit a more pronounced diving-response than non-divers, while elite BHDs (EBHDs) also display beneficial adaptations in both blood and skeletal muscle. Importantly, these physiological characteristics are documented to be primarily influenced by training-induced stimuli. BHDs are exposed to unique physiological and environmental stressors, and as such possess an ability to withstand acute cerebrovascular and neuronal strains. Whether these characteristics are also a result of training-induced adaptations or genetic predisposition is less certain. Although the long-term effects of regular breath-hold diving activity are yet to be holistically established, preliminary evidence has posed considerations for cognitive, neurological, renal and bone health in BHDs. These areas should be explored further in longitudinal studies to more confidently ascertain the long-term health implications of extreme breath-holding activity.
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Aladağ N, Asoğlu R, Ozdemir M, Asoğlu E, Derin AR, Demir C, Demir H. Oxidants and antioxidants in myocardial infarction (MI): Investigation of ischemia modified albumin, malondialdehyde, superoxide dismutase and catalase in individuals diagnosed with ST elevated myocardial infarction (STEMI) and non-STEMI (NSTEMI). J Med Biochem 2021; 40:286-294. [PMID: 34177373 PMCID: PMC8199596 DOI: 10.5937/jomb0-28879] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 11/25/2020] [Indexed: 11/02/2022] Open
Abstract
Background Coronary ischemia can lead to myocardial damage and necrosis. The pathogenesis of cardiovascular diseases often includes increased oxidative stress and decreased antioxidant defense. The study aimed to assess levels of ischemia modified albumin (IMA), malondialdehyde acid (MDA), superoxide dismutase (SOD), and catalase in individuals diagnosed with ST elevated myocardial infarction (STEMI) and non-STEMI. Methods The present study prospectively included 50 STEMI patients, 55 NSTEMI patients, and 55 healthy subjects. Only patients who were recently diagnosed with STEMI or NSTEMI were included in this study. IMA, MDA, SOD, and catalase activities were measured spectrophotometrically. Significant coronary artery lesions were determined by angiography. Results Patients with ACS had significantly greater IMA and MDA values than the healthy controls (p<0.001). Besides, patients with STEMI had IMA levels that were significantly greater than those of the patients with NSTEMI (p<0.001), while the reverse was true for MDA levels (p<0.001). The healthy controls had the highest levels of SOD and catalase levels, followed by patients with STEMI and patients with NSTEMI, respectively (p<0.001). There was a significant negative correlation among MDA and SOD with catalase levels (r = -0.771 p<0.001 MDA vs catalase; r = -0.821 p<0.001 SOD vs catalase). Conclusions Data obtained in this study reveals that compared to healthy controls, STEMI and NSTEMI patients had increased levels of MDA and IMA and decreased levels of SOD and catalase.
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Affiliation(s)
- Nesim Aladağ
- Van Yuzuncu Yil University, Faculty of Medicine, Department of Cardiology, Van, Turkey
| | - Ramazan Asoğlu
- Adıyaman University, Training and Research Hospital, Cardiology Department, Adıyaman, Turkey
| | - Mahmut Ozdemir
- Bayrampa a Kolan Hospital, Cardiology Department, Istanbul, Turkey
| | - Emin Asoğlu
- Mardin Community Hospital, Cardiology Department, Mardin, Turkey
| | - Atabey Rukiye Derin
- University of Health Sciences, Van Training and Research Hospital, Cardiovascular Surgery Department, Van, Turkey
| | - Canan Demir
- Van Yüzüncü Yıl University, Vocational School of Health Services, Van, Turkey
| | - Halit Demir
- Van Yüzüncü Yıl University, Department of Biochemistry, Van, Turkey
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Yin M, Liu X, Chen X, Li C, Qin W, Han H, Guo H, Yang H, Cao D, Du Z, Wu D, Wang H. Ischemia-modified albumin is a predictor of short-term mortality in patients with severe sepsis. J Crit Care 2017; 37:7-12. [DOI: 10.1016/j.jcrc.2016.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/05/2016] [Accepted: 08/04/2016] [Indexed: 12/24/2022]
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Louge P, Coulange M, Beneton F, Gempp E, Le Pennetier O, Algoud M, Dubourg L, Naibo P, Marlinge M, Michelet P, Vairo D, Kipson N, Kerbaul F, Jammes Y, Jones IM, Steinberg JG, Ruf J, Guieu R, Boussuges A, Fenouillet E. Pathophysiological and diagnostic implications of cardiac biomarkers and antidiuretic hormone release in distinguishing immersion pulmonary edema from decompression sickness. Medicine (Baltimore) 2016; 95:e4060. [PMID: 27368044 PMCID: PMC4937958 DOI: 10.1097/md.0000000000004060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Immersion pulmonary edema (IPE) is a misdiagnosed environmental illness caused by water immersion, cold, and exertion. IPE occurs typically during SCUBA diving, snorkeling, and swimming. IPE is sometimes associated with myocardial injury and/or loss of consciousness in water, which may be fatal. IPE is thought to involve hemodynamic and cardiovascular disturbances, but its pathophysiology remains largely unclear, which makes IPE prevention difficult. This observational study aimed to document IPE pathogenesis and improve diagnostic reliability, including distinguishing in some conditions IPE from decompression sickness (DCS), another diving-related disorder.Thirty-one patients (19 IPE, 12 DCS) treated at the Hyperbaric Medicine Department (Ste-Anne hospital, Toulon, France; July 2013-June 2014) were recruited into the study. Ten healthy divers were recruited as controls. We tested: (i) copeptin, a surrogate marker for antidiuretic hormone and a stress marker; (ii) ischemia-modified albumin, an ischemia/hypoxia marker; (iii) brain-natriuretic peptide (BNP), a marker of heart failure, and (iv) ultrasensitive-cardiac troponin-I (cTnI), a marker of myocardial ischemia.We found that copeptin and cardiac biomarkers were higher in IPE versus DCS and controls: (i) copeptin: 68% of IPE patients had a high level versus 25% of DCS patients (P < 0.05) (mean ± standard-deviation: IPE: 53 ± 61 pmol/L; DCS: 15 ± 17; controls: 6 ± 3; IPE versus DCS or controls: P < 0.05); (ii) ischemia-modified albumin: 68% of IPE patients had a high level versus 16% of DCS patients (P < 0.05) (IPE: 123 ± 25 arbitrary-units; DCS: 84 ± 25; controls: 94 ± 7; IPE versus DCS or controls: P < 0.05); (iii) BNP: 53% of IPE patients had a high level, DCS patients having normal values (P < 0.05) (IPE: 383 ± 394 ng/L; DCS: 37 ± 28; controls: 19 ± 15; IPE versus DCS or controls: P < 0.01); (iv) cTnI: 63% of IPE patients had a high level, DCS patients having normal values (P < 0.05) (IPE: 0.66 ± 1.50 μg/L; DCS: 0.0061 ± 0.0040; controls: 0.0090 ± 0.01; IPE versus DCS or controls: P < 0.01). The combined "BNP-cTnI" levels provided most discrimination: all IPE patients, but none of the DCS patients, had elevated levels of either/both of these markers.We propose that antidiuretic hormone acts together with a myocardial ischemic process to promote IPE. Thus, monitoring of antidiuretic hormone and cardiac biomarkers can help to make a quick and reliable diagnosis of IPE.
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Affiliation(s)
- Pierre Louge
- Department of Hyperbaric Medicine, Sainte-Anne Hospital, Toulon
| | - Mathieu Coulange
- Department of Hyperbaric Medicine, Sainte-Marguerite Hospital, Marseille
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Frederic Beneton
- Department of Hyperbaric Medicine, Sainte-Marguerite Hospital, Marseille
| | - Emmanuel Gempp
- Department of Hyperbaric Medicine, Sainte-Anne Hospital, Toulon
| | - Olivier Le Pennetier
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Maxime Algoud
- Laboratory of Biochemistry, Timone University Hospital, Marseille
| | - Lorene Dubourg
- Laboratory of Biochemistry, Timone University Hospital, Marseille
| | - Pierre Naibo
- Laboratory of Biochemistry, Timone University Hospital, Marseille
| | - Marion Marlinge
- Laboratory of Biochemistry, Timone University Hospital, Marseille
| | - Pierre Michelet
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Donato Vairo
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Nathalie Kipson
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - François Kerbaul
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Yves Jammes
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Ian M. Jones
- School of Biological Sciences, University of Reading, United Kingdom
| | | | - Jean Ruf
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Régis Guieu
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
- Laboratory of Biochemistry, Timone University Hospital, Marseille
- Correspondence: Régis Guieu, Faculty of Medicine, Bd Dramard, (e-mail: )
| | - Alain Boussuges
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
| | - Emmanuel Fenouillet
- UMR MD2, Aix-Marseille University and Institute of Biological Research of the Army
- Institut des Sciences Biologiques, CNRS, France
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Joulia F, Coulange M, Lemaitre F, Desplantes A, Costalat G, Bruzzese L, Franceschi F, Barberon B, Kipson N, Jammes Y, Guieu R. Ischaemia-modified albumin during experimental apnoea. Can J Physiol Pharmacol 2015; 93:421-6. [PMID: 25789402 DOI: 10.1139/cjpp-2014-0538] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ischaemia-modified albumin (IMA) is a marker of the release of reactive oxygen species (ROS) during hypoxaemia. In elite divers, breath-hold induces ROS production. Our aim was to evaluate the kinetics of IMA serum levels during apnea. Twenty breath-hold divers were instructed to perform a submaximal static breath-hold. Twenty non-diver subjects served as controls. Blood samples were collected at rest, every minute, at the end of breath-hold, and 10 min after recovery. The IMA level increased after 1 min of breath-hold (p < 0.003) and remained high until recovery. Divers were separated into 2 groups: subjects who held their breath for less than 4 min (G-4) and those who held it for more than 4 min (G+4). After 3 min of apnoea, the increase of IMA was higher in the G-4 group than in the G+4 group (p < 0.008). However, at the end of apnoea, the IMA level did not differ between groups. If IMA level was globally correlated with the apnoea duration, it is interesting to note that the higher IMA level was not found in the best divers. Similarly, if arterial blood oxygen saturation (SpO2) was globally inversely correlated with apnoea duration, the lowest SpO2 at the end of breath-hold was not found in the divers that performed the best apnoea. We concluded that these divers save their oxygen. The IMA level provides a useful measure of resistance to hypoxaemia.
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Affiliation(s)
- Fabrice Joulia
- UMR MD2, Aix Marseille Université and Institut de Recherche Biomédicale des Armées, Faculty de Medicine Nord, boulevard Pierre Dramard 13015 Marseille, France., Université de Toulon et du Var, avenue de l'Université, B.P. 20132-83957 La Garde Cedex, France
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Falkensammer J, Frech A, Duschek N, Gasteiger S, Stojakovic T, Scharnagl H, Huber K, Fraedrich G, Greiner A. Prognostic relevance of ischemia-modified albumin and NT-proBNP in patients with peripheral arterial occlusive disease. Clin Chim Acta 2014; 438:255-60. [PMID: 25195005 DOI: 10.1016/j.cca.2014.08.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 08/25/2014] [Accepted: 08/25/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cardiovascular morbidity is high among patients with peripheral arterial occlusive disease (PAOD). The aim of this study was to evaluate the ability of ischemia-modified albumin (IMA), N-terminal proBNP (NT-proBNP), and high-sensitive cardiac Troponin T (hs-cTnT) to predict cardiovascular complications in male patients with Fontaine stage II PAOD. METHODS 68 men with stage II PAOD underwent treadmill testing. NT-proBNP, IMA and hs-cTnT were measured before and after exercise. Patients were followed up prospectively and complete follow-up data were available for 66 individuals. RESULTS Median follow-up time was 43.0months. 12 (18.2%) patients had suffered from a major adverse cardiac event (MACE). IMA and NT-proBNP baseline concentrations were significantly higher in patients who developed MACE during follow-up: IMA: 110.6±2.4kU/L vs. 102.5±0.9kU/L (p<0.001); NT-proBNP: 270.5±295.9ng/L vs. 84.6±15.4ng/L (p=0.007). In multivariable regression models only IMA was significantly associated with the primary endpoint (HR=1.07, CI 1.01-1.13; p=0.029). CONCLUSION In the present study, a serum concentration of >103.9kU/L of IMA was a better independent predictor of MACE than NT-proBNP or hs-cTnT. IMA might be a valuable tool for risk stratification in PAOD patients.
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Affiliation(s)
- Jürgen Falkensammer
- Department of Vascular and Endovascular Surgery, Wilhelminen hospital, Vienna, Austria; Department of Vascular Surgery, Medical University Innsbruck, Austria.
| | - Andreas Frech
- Department of Vascular Surgery, Medical University Innsbruck, Austria
| | - Nikolaus Duschek
- Department of Vascular and Endovascular Surgery, Wilhelminen hospital, Vienna, Austria
| | - Simon Gasteiger
- Department of Vascular Surgery, Medical University Innsbruck, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | - Kurt Huber
- 3rd Medical Department, Cardiology, Wilhelminen hospital, Vienna, Austria
| | - Gustav Fraedrich
- Department of Vascular Surgery, Medical University Innsbruck, Austria
| | - Andreas Greiner
- Department of Vascular Surgery, Medical University Innsbruck, Austria; Department of Vascular Surgery, University Hospital Aachen, Germany
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Yayan J. Emerging families of biomarkers for coronary artery disease: inflammatory mediators. Vasc Health Risk Manag 2013; 9:435-56. [PMID: 23983474 PMCID: PMC3751465 DOI: 10.2147/vhrm.s45704] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Introduction Inflammation has been implicated in the development of atherosclerosis in patients with acute coronary syndrome. C-reactive protein is an established nonspecific prognostic inflammatory biomarker for patients with acute coronary syndrome in the medical literature. This has led to a concerted effort to identify circulating inflammatory biomarkers to facilitate predicting the risk for and diagnosing coronary artery disease in at-risk subjects. The objective of this study was to search after novel inflammatory biomarkers reported as useful for diagnosing coronary artery disease. Methods The PubMed database was searched for reports published from January 1, 2000 to June 30, 2012 of novel circulating biomarkers for coronary artery disease in addition to the established biomarker, C-reactive protein. The search terms used were “infarction”, “biomarkers”, and “markers”, and only original articles describing clinical trials that were written in English were included. All published articles were separately examined carefully after novel inflammatory markers for acute coronary syndrome. All irrelevant publications without content pertaining to inflammatory biomarkers for acute coronary syndrome were excluded from this study. Our results reflect all articles concerning biomarkers in humans. Results The PubMed search yielded 4,415 research articles. After further analysis, all relevant published original articles examining 53 biomarkers were included in this review, which identified 46 inflammation biomarkers useful for detecting coronary artery disease. Conclusion The emergence of diverse novel biomarkers for coronary artery disease has provided insight into the varied pathophysiology of this disease. Inflammatory biomarkers have tremendous potential in aiding the prediction of acute coronary syndrome and recurrent ischemic episodes, and will eventually help improve patient care and management.
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Affiliation(s)
- Josef Yayan
- Department of internal Medicine, University Hospital of Saarland, Homburg/Saar, Germany.
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Mononuclear cell adenosine deaminase and CD26/dipeptidylpeptidase-IV activities are sensitive markers of reperfusion during percutaneous transluminal angioplasty. Int J Cardiol 2013; 166:225-9. [DOI: 10.1016/j.ijcard.2011.10.090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 09/21/2011] [Accepted: 10/18/2011] [Indexed: 11/21/2022]
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Jacquin L, Franceschi F, By Y, Durand-Gorde JM, Condo J, Deharo JC, Michelet P, Fenouillet E, Guieu R, Ruf J. Search for adenosine A2A spare receptors on peripheral human lymphocytes. FEBS Open Bio 2012; 3:1-5. [PMID: 23847753 PMCID: PMC3668538 DOI: 10.1016/j.fob.2012.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 11/12/2012] [Accepted: 11/13/2012] [Indexed: 12/20/2022] Open
Abstract
Some ligand–receptor couples involve spare receptors, which are apparent when a maximal response is achieved with only a small fraction of the receptor population occupied. This situation favours cross-reactions with low-affinity ligands, which may be detrimental for cell signaling. In the case of the adenosine A2A receptors (A2AR), which have an immunosuppressive effect on lymphocytes through cAMP production, the presence of spare A2AR remains to be established. We examined the situation using patients over-expressing lymphocyte A2AR and an agonist-like mAb to A2AR. We found that maximal mAb binding and functional response varied among the patients whereas the dissociation constant and half-maximal effective concentration had similar mean values (0.19 and 0.18 μM, respectively). Lymphocyte A2AR expression was correlated to plasma adenosine level and A2AR occupation but not to A2AR response. These results are consistent with a lack of a reserve of functional A2AR on human lymphocytes as a general rule and suggest that the amount and functional state of the expressed A2AR determine the maximal level of the lymphocyte response to adenosine.
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Affiliation(s)
- Laurent Jacquin
- Aix-Marseille Université, UMR MD2, Faculté de Médecine Nord, Marseille, France
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Koc ZP, Erkilic M, Basarıcı I, Deger N, Ozdem S, Saka O. Ischemia modified albumin levels cannot predict stress induced ischemia shown by myocardial perfusion scintigraphy. Rev Esp Med Nucl Imagen Mol 2012; 31:202-6. [PMID: 22980127 DOI: 10.1016/j.remn.2012.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 02/15/2012] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Ischemia modified albumin (IMA) is a new marker of ischemia which is used in especially emergency room. Aim of this study is showing the association of IMA with stress induced ischemia on Tc-99m 2-methoxyisobutyl-nitrate (MIBI) myocardial perfusion scintigraphy (MPS). METHODS 56 patients (23 F, 33 M; 56.04 ± 8.45 years old) were included in our study. Stress-rest two days protocol Tc-99m MIBI MPS single photon emission tomography (SPECT) was performed to all patients. IMA levels from the blood samples which were taken before and after the treadmill test were measured. Thirty patients additionally underwent coronary angiography. RESULTS The difference of IMA levels of ischemia between positive and negative groups was not statistically significant. Also, there was not statistically significant difference between IMA levels of patients who have narrowing in the coronary arteries and not. CONCLUSION Although IMA is an important marker of ischemia, probably because of other ischemic process during stress; it cannot reflect stress induced ischemic changes on MPS.
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Affiliation(s)
- Z P Koc
- Nuclear Medicine Department, Firat University Medical Faculty, Elazig, Turkey.
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Koc Z, Erkilic M, Basarıcı I, Deger N, Ozdem S, Saka O. Ischemia modified albumin levels cannot predict stress induced ischemia shown by myocardial perfusion scintigraphy. Rev Esp Med Nucl Imagen Mol 2012. [DOI: 10.1016/j.remnie.2012.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bhardwaj A, Truong QA, Peacock WF, Yeo KTJ, Storrow A, Thomas S, Curtis KM, Foote RS, Lee HK, Miller KF, Januzzi JL. A multicenter comparison of established and emerging cardiac biomarkers for the diagnostic evaluation of chest pain in the emergency department. Am Heart J 2011; 162:276-282.e1. [PMID: 21835288 DOI: 10.1016/j.ahj.2011.05.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 05/27/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND The aim of this study is to assess the role of novel biomarkers for the diagnostic evaluation of acute coronary syndrome (ACS). METHODS Among 318 patients presenting to an emergency department with acute chest discomfort, we evaluated the diagnostic value of 5 candidate biomarkers (amino terminal pro-B-type natriuretic peptide [NT-proBNP], ischemia modified albumin, heart fatty acid binding protein, high-sensitivity troponin I [hsTnI], and unbound free fatty acids [FFAu]) for detecting ACS, comparing their results with that of conventional troponin T (cTnT). RESULTS Sixty-two subjects (19.5%) had ACS. The sensitivity and negative predictive values of NT-proBNP (73%, 90%) and hsTnI (57%, 89%) were higher than that of cTnT (22%, 84%). Unbound free fatty acids had the highest overall combination of sensitivity (75%), specificity (72%), and negative predictive values (92%) of all the markers examined. A significant increase in the C-statistic for cTnT resulted from the addition of results for NT-proBNP (change 0.09, P = .001), hsTnI (change 0.13, P < .001), and FFAu (change 0.15, P < .001). In integrated discrimination improvement and net reclassification improvement analyses, NT-proBNP, hsTnI, and FFAu added significant diagnostic information to cTnT; when changing the diagnostic criterion standard for ACS to hsTnI, FFAu still added significant reclassification for both events and nonevents. In serial sampling (n = 180), FFAu added important reclassification information to hsTnI. CONCLUSION Among emergency department patients with symptoms suggestive of ACS, neither ischemia modified albumin nor heart fatty acid binding protein detected or excluded ACS, whereas NT-proBNP, hsTnI, or FFAu added diagnostic information to cTnT. In the context of hsTnI results, FFAu measurement significantly reclassified both false negatives and false positives at baseline and in serial samples.
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Sbarouni E, Georgiadou P, Voudris V. Ischemia modified albumin changes – review and clinical implications. Clin Chem Lab Med 2011; 49:177-84. [DOI: 10.1515/cclm.2011.037] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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