Ischemia-Modified Albumin: Its Diagnostic Implications and Shortfalls

Patients presenting with chief complaint of chest pain or other signs suggestive of acute coronary syndrome (ACS) in hospital is often time-consuming, expensive and problematic to arrive to the definitive diagnosis for the cause of chest pain. Recent research has found that ischemia-modified albumin (IscMA) is an ideal biomarker for ischemia. It is highly sensitive and detectable in the early phase of ACS. Many clinical studies have demonstrated that IscMA can be used for early diagnosis of acute myocardial infarction (AMI), so that the admission rate of non-ischemic patients can be reduced allowing the relieve from the heavy cost burdened on admission to Intensive Coronary Care Unit (ICCU). Ischemia modified albumin which is proposed biomarker for myocardial ischemia is detected within six to ten minutes and remains elevated for up to several hours later. Although, it was thought as an evident biomarker for ischemia process in AMI and ACS, but it’s no doubt that the elevations are also accompanied in various other diseases where the process of ischemia occurs. Studies have surfaced the elevation of IscMA is other diseases too, namely diabetes, hypertension, in smokers, in patients with peripheral vascular disease, skeletal muscle ischemia, end stage renal disease, in cirrhosis of liver, systemic sclerosis, etc. It is the right time to unveil the exact mechanisms of elevation of IscMA which is accompanied in various diseased states.