title: Change in ischemia-modified albumin and its clinical significance during exercise stress testing.
abstract: BACKGROUND
  There is little data about the additive effects of ischemia-modified albumin (IMA) on the exercise stress test (EST) used for the screening of ischemic heart disease. The relationship between myocardial ischemic burden and the change in IMA (DeltaIMA) during EST was investigated.
  
  
  RESULTS
  EST was performed using the Bruce protocol to evaluate chest pain or exertional dyspnea in 155 patients (men 89, 53+/-13 years). Blood samples for IMA were obtained before and immediately after EST. According to the EST results and the pattern of DeltaIMA, patients were categorized into 3 groups (none was classified as EST(-)/DeltaIMA(+)): (1) (EST(-); (2) EST(+)/DeltaIMA(-); and (3) EST(+)/DeltaIMA(+). After EST, 60 of 155 (38.7%) patients were EST(+) and 14/60 (23.3%) were EST(+)/DeltaIMA(+). Duke treadmill score was significantly lower in the EST(+)/DeltaIMA(+) group compared with the other groups (-9.0+/-7.9, -1.7+/-4.2, 6.7+/-4.4, respectively, P<0.001); 43/60 (72%) patients with EST(+) underwent coronary angiography and the proportion of patients with a large ischemic burden was higher in the EST(+)/DeltaIMA(+)group compared with the EST(+)/DeltaIMA(-) group (72.7% vs 15.6%, P=0.001).
  
  
  CONCLUSIONS
  Increased IMA after EST suggests a large ischemic burden in coronary artery disease, so the DeltaIMA during EST may be useful for predicting the severity of myocardial ischemia.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, The Catholic University of Medical College, Uijongbu city, Kyungki-do, Republic of Korea.
authors.forename: Dong-Hyeon
authors.initials: DH
authors.lastname: Lee
authors.forename: Hui-Kyung
authors.initials: HK
authors.lastname: Jeon
authors.forename: Hun-Jun
authors.initials: HJ
authors.lastname: Park
authors.forename: Woo-Seung
authors.initials: WS
authors.lastname: Shin
authors.forename: Seung-Won
authors.initials: SW
authors.lastname: Lee
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Youn
authors.forename: Chul-Min
authors.initials: CM
authors.lastname: Kim
authors.forename: Hae Kyung
authors.initials: HK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002637:Chest Pain / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D004417:Dyspnea / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D015444:Exercise; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012709:Serum Albumin / Q000378:metabolism*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D012709:Serum Albumin