Changes Of Plasma Level And Clinical Significance Of IMA Before And After Percutaneous Coronary Intervention In Patients With Coronary Heart Disease

Objective To investigate changes of plasma level of ischemia modified albumin(IMA), cTnT and CKMB in patients with coronary heart disease before and after successful coronary artery stent placement. The aim of the present study was to determine whether IMA could be a useful biomarker in detecting myocardial ischemia during percutaneous coronary intervention(PCI), and whether elevated IMA levels was related to cardiac function post PCI.Methods percutaneous coronary intervention was performed in 22 patients with angina pectoris(AP) and 38 patients with acute myocardial infarction(AMI,10-14days after attack),who were divided into two groups of A and B. Group A comprises patients with their infarction relative artery(IRA) reflow, and group B comprises patients with occluded IRA before PCI. Another 20 patients performed only coronary angiography. The plasma levels of IMA, cTnT and CKMB was measured before,0.5h, 6h, 12h after PCI. The number of balloon inflations, inflation pressure, and duration of inflations were also recorded. Left ventricular ejection fraction(LVEF) were measured in all patients before and 6 months after PCI. The IMA measured was performed using an indirect method based in the Albumin Cobalt Binding (ACB) colorimetric assay. The decrease of ACB indicated an elevation of IMA.Results Before PCI ,the level of cTnT were slightly higher in patients of group A and group B than in those with AP and those just performed CAG. CKMB and ACB were normal in all patients before PCI. ACB dropped significantly half an hour after PCI in those patients of group A and group B, and patients with AP, 55.72±6.07 vs 71.58±4.18(P<0.01),66.21±3.86vs70.93±4.38(P<0.01),59.85±5.12vs72.87±3.19(P<0.01),and returned to normal 6hrs later. cTnT elevated 12hrs after PCI in patients of group A,B and patients with AP. CKMB has no significant change in all patients before and after PCI. correlation between balloon inflation pressure ,durations of inflation , number of inflation AND ACB of half an hour after PCI were found, with R/P value of -0.584/0.011,-0.534/0.022,-0.563/0.015 respectively in group A, and -0.698/0.000, -0.628/0.002, -0.690/0.000respectively in AP. LVEF were elevated in all patients 6 months after PCI. The ACB value of 0.5h after PCI was associated with the LVEF improvement in group B. Conclusion IMA levels rise in patients who develop ischemia during percutaneous coronary intervention, earlier than cTnT and CKMB. IMA levels are associated with the number of balloon inflations, inflation pressure, and duration of inflations . The IMA levels are associated with LVEF improvement in those patients who suffered from acute myocardial infarction 2 weeks before PCI with occluded infarction related artery PCI.