Ischemia-modified albumin in acute stroke.
BACKGROUND
Ischemia-modified albumin (IMA)is a new biological marker of ischemia. Previous studies have found increased serum IMA levels after myocardial ischemia, but no study has investigated the possibility that stroke modifies IMA blood levels.


METHODS
We studied 118 consecutive patients presenting within 3 h of the onset of an acute neurological deficit [84 brain infarctions (BI), 18 brain hemorrhages (ICH) and 16 transient ischemic attacks lasting less than 1 h or epileptic seizures]. Serum samples were obtained for all patients at initial presentation and repeated only in patients with stroke at 6, 12 and 24 h. IMA was measured by the albumin-cobalt-binding test (Ischemia Technologies, Denver, Colo., USA).


RESULTS
The initial median IMA (bootstrap 95% confidence interval, CI) was 83 U/ml (79-86) and 86 U/ml (75-90) in patients with BI and ICH, respectively (p = 0.76), and was 73 U/ml (58-79) in others (p = 0.003 compared with BI, and p = 0.017 with ICH). Baseline IMA levels correlated with the National Institutes of Health Stroke Scale [Spearman correlation coefficient: 0.34 (p = 0.002) in BI, 0.61 (p = 0.008) in ICH]. During the first 24 h, IMA levels increased in BI patients (median, 9.1%; bootstrap 95% CI, 5.2-11.5), whereas no change was observed in ICH patients (median, 1.2%; bootstrap 95% CI, -7.8 to 6.8).


CONCLUSIONS
IMA blood levels may be a biomarker for early identification of acute stroke. Further studies are required to investigate the role of IMA in the early detection of acute stroke.
Abboud
Halim
H
Department of Neurology and Stroke Center, Bichat University Hospital, Denis Diderot University and Medical School, Paris, France.
Labreuche
Julien
J
Meseguer
Elena
E
Lavallee
Philippa C
PC
Simon
Olivier
O
Olivot
Jean-Marc
JM
Mazighi
Mikael
M
Dehoux
Monique
M
Benessiano
Joelle
J
Steg
Philippe Gabriel
PG
Amarenco
Pierre
P
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D020520:Brain Infarction / Q000097:blood / Q000150:complications*; D004827:Epilepsy / Q000097:blood*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000097:blood / Q000150:complications*; D002546:Ischemic Attack, Transient / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000378:metabolism*; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D013997:Time Factors
D015415:Biomarkers; D012709:Serum Albumin