Abstract 10883: Ischemia-Modified Albumin in Acute Decompensated Heart Failure: IMA-HF Study
Purpose: Ischemia-modified albumin (IMA) is a sensitive marker of ischemia, even in the absence of myocardial damage. IMA has also been found to be elevated in the setting of oxidative stress, acidosis, hypoxia, free radical injury, inflammatory state and sodium and calcium pump disruptions which are also involved in the pathophysiologic process of heart failure (HF). However, prospective studies examining IMA levels specifically in patients with HF are still lacking. Therefore, the aim of this multicenter, propective study was to evaluate IMA levels and its diagnostic ability in patients presenting with acute decompensated HF.
Methods: This prospective study was performed at the five independent sites. Seventy patients admitted to participating centers with clinical signs and symptoms of NYHA III-IV acute decompensated HF and LVEF <35% were enrolled in this study. Serum concentrations of IMA were measured from blood sample collected before the initiation of HF therapy. A control reference population consisted of 32 apparently healthy age-matched individuals. IMA concentrations were measured by albumin cobalt binding colorimetric assay and results were given as absorbance units (AU). The diagnostic performance of IMA was assessed by Receiver Operator Characteristic (ROC) curve analysis.
Results: In patients with acute decompensated HF, mean serum concentration of IMA was found to be significantly higher than those of control reference population (0.894±0.23 AU vs 0.379±0.08 AU, p <0.0001). The area under the ROC curve (AUC) was 0.97 (95% CI, 0.90-0.99, p=0.0001) for the diagnosis of HF with a diagnostic cutoff point of 0.578 AU. The sensitivity and specificity were 92.8% (95% CI, 0.84-0.97) and 100% (95% CI, 0.89-100), respectively. Positive and negative predictive values were found to be 100% (95% CI, 0.94-100) and 86.5% (95% CI, 0.71-0.95), respectively.
Conclusions: The preliminary results of this study, for the first time, showed that patients presenting with acute decompensated HF had elevated levels of IMA when compared to healthy controls. This study also suggested that IMA as a highly sensitive marker, at least with the cutoff point of 0.578 AU, may have a considerable diagnostic potential for the assessment of acute decompensated HF.
- © 2012 by American Heart Association, Inc.