Ischemia-modified albumin use as a prognostic factor in coronary bypass surgery

Background: Various types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA) is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops. Methods and Results: 30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia) of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean +/- SD) of IMA (0.67677 +/- 0.09985) were statistically significantly higher than those in the preoperative (0.81516 +/- 0.08894) and postoperative (0.70477 +/- 0.07523) measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA. Conclusions: IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.