Changes And Clinical Significance Of Serum Ischemia Modified Albumin On Percutaneous Coronary Intervention

Objectives: It has been shown that the concentrations of ischemia modified albumin (IMA), which appears earlier than cardiac Troponin I (cTnI) and creatine kinase-MB (CK-MB), are increased in patients with cardiac ischemia. At present, percutaneous coronary intervention (PCI) has been extensively used to treat coronary heart disease (CHD). Transient coronary occlusion during PCI can lead to cardiac ischemia and oxygen deficit. The present study aims to investigate the changes of IMA in CHD patients who underwent PCI and explore the clinical significance.Methods: Seventy patients with coronary heart disease (CHD) in our hospital between September 2006 and February 2007 were studied. Fifteen of them accepted emergent PCI because of acute myocardial infarction (emergent PCI group, n=15); the patients with subacute myocardial infarction (n=9),unstable angina (n=18) and stable angina (n=8) accepted selective PCI (selective PCI group, n=35). Twenty CHD patients, who have been confirmed by coronary angiography, didn't accept intervention therapy were selected as controls (control group, n=20). The levels of IMA,cTnI and CK-MB before PCI and 0.5, 6, 12 hrs after PCI were measured in all patients.To those patients who received PCI, we recorded the total pressure of inflation,total duration of inflations,number of inflations and the place and number of stein insertion,the change of ECG in and 24 hrs after PCI in detail.Results: Among emergent PCI group, when compared with pre-operation, the levels of IMA significantly increased in all 15 patients at 0.5 hrs after operation (P<0.01), and the baseline began to decrease at 6 hrs after operation. The concentrations of cTnI in 3 patients increased before operation, 4 patients increased 0.5h after operation, 10 patients increased at 6h after operation (P>0.05), the levels of cTnI in 10 patients increased at 12h after operation (P<0.05). The levels of CK-MB in 2 patients increased at 6h after operation (P>0.05), 5 patients increased at 12h after operation (P<0.05). Among selective PCI group, the levels of IMA in all 30 patients increased at 0.5hrs after operation and began to decreased at 6hrs , then returned to normal at 12h. The levels of cTnI in 11 patients increased at 6h after operation and 14 patients increased at 12h after operation (P>0.05). The levels of CK-MB in 3 patients increased at 12h after operation but not exceeded 2 times of the normal value. In control group, IMA,cTnI and CK-MB levels remained unchanged before and after angiography (P>0.05). Compared with the selective PCI group and control group, the levels of IMA significantly increased in emergent group before operation (P<0.05), and IMA levels both increased in selective and emergent group at 0.5hrs after operation (P<0.05). The levels of IMA are closely related to the total pressure of inflation,total duration of inflations and number of inflations.Conclusion: IMA is a biomarker of early diagnosis of myocardial ischemia. Because of the light injuries to myocardium during PCI, the concentrations of IMA, which appears earlier than cTnI and CK-MB, increase significantly and immediately after angiography. The levels of IMA are closely related to the total pressure of inflation,total duration of inflations and number of inflations.