Ischemia-modified albumin is not better than creatine kinase-MB and cardiac troponin I in predicting a cardiac injury in nontraumatic subarachnoid hemorrhage

Am J Emerg Med. 2015 Apr;33(4):488-92. doi: 10.1016/j.ajem.2014.10.007. Epub 2014 Oct 12.

Abstract

Background: The aims were to investigate the role of serum ischemia-modified albumin (IMA), tumor necrosis factor α (TNF-α), and myeloperoxidase (MPO) and to evaluate the relationship between IMA and cardiac markers (creatine kinase myocardial isoenzyme [CK-MB] and cardiac troponin I [cTnI]) related to cardiac abnormalities in adult patients after nontraumatic subarachnoid hemorrhage (SAH).

Methods: Twenty-nine patients with nontraumatic SAH admitted to the emergency department and 20 healthy adults as the control group were included in the study. Ischemia-modified albumin, TNF-α, MPO, CK-MB, cTnI, and leukocyte count (white blood cell [WBC]) in the circulation were measured on admission.

Results: Ischemia-modified albumin, TNF-α, and MPO levels were higher by mean values of 11.6%, 9.5%, and 2.9%, respectively, in patients with SAH compared with control group. However, levels of these parameters were not statistically different between the groups (P > .05). However, WBC, CK-MB, and cTnI values were significantly higher in patients with SAH compared with healthy control (P < .001, P < .01, and P < .05, respectively). White blood cell and cTnI levels in the circulation were positively correlated with patients' clinical severity (r = 0.598, P = .001 and r = 0.461, P = .012, respectively). Ischemia-modified albumin has a poor diagnostic value in comparison with WBC, CK-MB, and cTnI tests to differentiate between patients after SAH and controls according to receiver operating characteristic curve.

Conclusions: The results suggest that IMA is not better than CK-MB and cTnI in predicting a cardiac injury in patients after nontraumatic SAH.

MeSH terms

  • Biomarkers / blood
  • Creatine Kinase, MB Form / blood*
  • Electrocardiography
  • Female
  • Heart Diseases / blood*
  • Heart Diseases / etiology*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Serum Albumin
  • Serum Albumin, Human
  • Subarachnoid Hemorrhage / blood*
  • Subarachnoid Hemorrhage / complications*
  • Troponin I / blood*

Substances

  • Biomarkers
  • Serum Albumin
  • Troponin I
  • ischemia-modified albumin
  • Creatine Kinase, MB Form
  • Serum Albumin, Human