Clinical significance of ischemia-modified albumin in the diagnosis of doxorubicin-induced myocardial injury in breast cancer patients.
BACKGROUND
Ischemia-modified albumin is an altered serum albumin that forms under conditions of oxidative stress, a state also associated with doxorubicin-induced myocardial injury.


OBJECTIVE
The aim of this study was to better assess diagnostic and prognostic significance of ischemia-modified albumin in patients with breast cancer undergoing doxorubicin chemotherapy.


METHODS
Blood samples were collected from 152 breast cancer patients before and after each cycle of doxorubicin chemotherapy to measure the serum levels of ischemia-modified albumin, cardiac troponin T and creatine kinase-MB. We also monitored cardiac function during a 12 month follow-up.


RESULTS
There was a significant difference in ischemia-modified albumin levels before and after each cycle of chemotherapy and the ischemia-modified albumin concentration positively correlated with the cumulative dose of doxorubicin (r = 0.212, P < 0.05). The combination of ischemia-modified albumin with cardiac troponin T and creatine kinase-MB increased the sensitivity to 0.920 and the specificity to 0.830 in the diagnosis of doxorubicin-induced myocardial injury. The optimal cutoff for ischemia-modified albumin concentration was 112.09 U/ml. The rate of change for ischemia-modified albumin levels correlated negatively with the rate of change for left ventricular ejection fraction at one year (r = -0.221, P < 0.05).


CONCLUSIONS
Ischemia-modified albumin may be a clinically potential new marker for diagnosing doxorubicin-induced myocardial injury, and is helpful to predict long-term impairment of cardiac function.
Department of Cancer, The 463rd Hospital of the Chinese PLA, Shenyang, Liaoning, People's Republic of China.
Yinghuan
Y
Ma
Wanjun
W
Kang
Yongxin
Y
Bao
Fubin
F
Jiao
Yiran
Y
Ma
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000188:drug therapy*; D052279:Creatine Kinase, MB Form / Q000097:blood; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006335:Heart Injuries / Q000097:blood* / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012709:Serum Albumin; D000075462:Serum Albumin, Human; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; D012709:Serum Albumin; D020107:Troponin T; C561522:ischemia-modified albumin; D004317:Doxorubicin; D052279:Creatine Kinase, MB Form; D000075462:Serum Albumin, Human