Ischemia-Modified Albumin in Acute StrokeAbboud H.a · Labreuche J.a · Meseguer E.a · Lavallee P.C.a · Simon O.a · Olivot J.-M.a · Mazighi M.a · Dehoux M.b · Benessiano J.c · Steg P.G.d · Amarenco P.a
aDepartment of Neurology and Stroke Center, bDepartment of Biochemistry, cCenter for Clinical Investigation and dDepartment of Cardiology, Bichat University Hospital, Denis Diderot University and Medical School, Paris, France
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Background: Ischemia-modified albumin (IMA)is a new biological marker of ischemia. Previous studies have found increased serum IMA levels after myocardial ischemia, but no study has investigated the possibility that stroke modifies IMA blood levels. Materials and Methods: We studied 118 consecutive patients presenting within 3 h of the onset of an acute neurological deficit [84 brain infarctions (BI), 18 brain hemorrhages (ICH) and 16 transient ischemic attacks lasting less than 1 h or epileptic seizures]. Serum samples were obtained for all patients at initial presentation and repeated only in patients with stroke at 6, 12 and 24 h. IMA was measured by the albumin-cobalt-binding test (Ischemia Technologies, Denver, Colo., USA). Results: The initial median IMA (bootstrap 95% confidence interval, CI) was 83 U/ml (79–86) and 86 U/ml (75–90) in patients with BI and ICH, respectively (p = 0.76), and was 73 U/ml (58–79) in others (p = 0.003 compared with BI, and p = 0.017 with ICH). Baseline IMA levels correlated with the National Institutes of Health Stroke Scale [Spearman correlation coefficient: 0.34 (p = 0.002) in BI, 0.61 (p = 0.008) in ICH]. During the first 24 h, IMA levels increased in BI patients (median, 9.1%; bootstrap 95% CI, 5.2–11.5), whereas no change was observed in ICH patients (median, 1.2%; bootstrap 95% CI, –7.8 to 6.8). Conclusions: IMA blood levels may be a biomarker for early identification of acute stroke. Further studies are required to investigate the role of IMA in the early detection of acute stroke.
© 2007 S. Karger AG, Basel
- Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, Schramm P, Juttler E, Oehler J, Hartmann M, Hahnel S, Knauth M, Hacke W, Sartor K: CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 2002;33:2206–2210.
- Apple FS, Wu AH, Mair J, Ravkilde J, Panteghini M, Tate J, Pagani F, Christenson RH, Mockel M, Danne O, Jaffe AS: Future biomarkers for detection of ischemia and risk stratification in acute coronary syndrome. Clin Chem 2005;51:810–824.
- Apple FS, Quist HE, Otto AP, Mathews WE, Murakami MM: Release characteristics of cardiac biomarkers and ischemia-modified albumin as measured by the albumin cobalt-binding test after a marathon race. Clin Chem 2002;48:1097–1100.
- Simel DL, Samsa GP, Matchar DB: Likelihood ratios with confidence: sample size estimation for diagnostic test studies. J Clin Epidemiol 1991;44:763–770.
- Bar-Or D, Winkler JV, Vanbenthuysen K, Harris L, Lau E, Hetzel FW: Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: a preliminary comparison to creatine kinase-MB, myoglobin, and troponin I. Am Heart J 2001;141:985–991.
- Sadler PJ, Tucker A, Viles JH: Involvement of a lysine residue in the N-terminal Ni2+ and Cu2+ binding site of serum albumins: comparison with Co2+, Cd2+ and Al3+. Eur J Biochem 1994;220:193–200.
- Bar-Or D, Lau E, Winkler JV: A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia – A preliminary report. J Emerg Med 2000;19:311–315.
- Gidenne S, Ceppa F, Fontan E, Perrier F, Burnat P: Analytical performance of the albumin cobalt binding (ACB) test on the Cobas MIRA Plus analyzer. Clin Chem Lab Med 2004;42:455–461.
- Zini I, Tomasi A, Grimaldi R, Vannini V, Agnati LF: Detection of free radicals during brain ischemia and reperfusion by spin trapping and microdialysis. Neurosci Lett 1992;138:279–282.
- Christenson RH, Duh SH, Sanhai WR, Wu AH, Holtman V, Painter P, Branham E, Apple FS, Murakami M, Morris DL: Characteristics of an albumin cobalt binding test for assessment of acute coronary syndrome patients: a multicenter study. Clin Chem 2001;47:464–470.
- Laer S, Block F, Huether G, Heim C, Sontag KH: Effect of transient reduction of cerebral blood flow in normotensive rats on striatal dopamine-release. J Neural Transm Gen Sect 1993;92:203–211.
- Heim C, Zhang J, Lan J, Sieklucka M, Kurz T, Riederer P, Gerlach M, Sontag KH: Cerebral oligaemia episode triggers free radical formation and late cognitive deficiencies. Eur J Neurosci 2000;12:715–725.
- Pozzilli C, Lenzi GL, Argentino C, Bozzao L, Rasura M, Giubilei F, Fieschi C: Peripheral white blood cell count in cerebral ischemic infarction. Acta Neurol Scand 1985;71:396–400.
- Alexandrova M, Bochev P, Markova V, Bechev B, Popova M, Danovska M, Simeonova V: Dynamics of free radical processes in acute ischemic stroke: influence on neurological status and outcome. J Clin Neurosci 2004;11:501–506.
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