Evaluation of effects of ischaemia on the albumin cobalt binding (ACB) assay in patients exposed to trauma.
BACKGROUND
In the emergency department (ED), the diagnosis of acute myocardial ischaemia is very difficult because of the absence of a rapid, reliable diagnostic test. The albumin cobalt binding (ACB) assay is a good candidate as a marker for for detection of myocardial ischaemia, as it is an easy and rapid test. To date, however, the way in which alterations in metal binding sites of human serum albumin depend on ischaemic events has not been reported in detail.


METHODS
We studied 92 patients admitted to the ED within 1 hour after exposure to trauma. Trauma patients divided into two groups according to their Injury Severity Score (ISS): group 1 comprised mildly injured patients who had ISS trauma score <15 (n = 60), and group 2 comprised moderately injured patients with ISS trauma score >15 (n = 32). The blood specimens of 30 healthy volunteers were studied as a control group.


RESULTS
Group 2 showed significantly increased ACB levels (0.63 (0.18) absorbance units (ABSU)) compared with group 1 (0.54 (0.14) ABSU) (p<0.05) and controls (0.39 (0.05) ABSU) (p<0.01). Group 1 showed significantly enhanced ACB values compared with controls (0.54 (0.14) v 0.39 (0.05) ABSU) (p<0.01).


CONCLUSIONS
Consequently, trauma enhances ACB levels, which may affect the diagnostic performance of the ACB assay, and this effect can limit the ability of the assay for detection of myocardial ischaemia in patients exposed to trauma.
Can
M
M
Department of Biochemistry, Karaelmas University of Medicine, Zonguldak, Turkey. drcanmurat@yahoo.com
Demirtas
S
S
Polat
O
O
Yildiz
A
A
D000208:Acute Disease; D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003035:Cobalt / Q000378:metabolism*; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000378:metabolism*; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D012709:Serum Albumin; D019210:Troponin I; D003035:Cobalt; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase