Document Detail


Ischemia-modified albumin levels predict long-term outcome in patients with acute myocardial infarction. The French Nationwide OPERA study.
MedLine Citation:
PMID:  20362714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known about the capacity of ischemia-modified albumin (IMA) plasma concentration to predict long-term cardiac outcome in patients with established acute myocardial infarction (AMI). Because IMA is a marker of ischemia rather than myocardial cell damage, we hypothesized that IMA plasma levels could provide additional prognostic value to classic clinical and biological risk markers in patients with AMI. Therefore, we investigated the predictive value of plasma IMA in patients with AMI enrolled in the French Nationwide OPERA study. METHODS: Plasma concentrations of IMA and other cardiac biomarkers (troponin, C-reactive protein, B-type natriuretic peptide) were measured within 24 hours of hospital admission in 471 patients hospitalized with an AMI (defined using European Society of Cardiology/American College of Cardiology criteria). Patients' characteristics, cardiovascular risk factors and treatments, and clinical outcomes were recorded. Univariate and multivariable predictors of cardiac outcome in-hospital and at 1 year were identified. RESULTS: The primary composite end point (death, resuscitated cardiac arrest, recurrent myocardial infarction or ischemia, heart failure, stroke) occurred in 75 (15.6%) patients in-hospital and in 144 (30.6%) at 1 year: 40% of patients in the highest IMA quartile (>104 IU/mL) reached the end point compared with 20% in the lowest (<83 IU/mL) by 1 year. Multivariable logistic regression analysis identified 4 independent predictors of composite end point at 1 year: plasma concentrations of IMA (P = .01), brain natriuretic peptide (P = .001), heart failure (P = .005), and age (P = .003). CONCLUSIONS: In patients with AMI, IMA measured within 24 hours is a strong and independent predictor of cardiac outcome at 1 year and may help identify those requiring more aggressive medical management.
Authors:
Eric Van Belle; Jean Dallongeville; Eric Vicaut; Alexia Degrandsart; Cathrine Baulac; Gilles Montalescot;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  159     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-05     Completed Date:  2010-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  570-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Mosby, Inc. All rights reserved.
Affiliation:
Hopital Cardiologique and EA2693, Lille, France. ericvanbelle@aol.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Albumins / analysis*
Female
France
Humans
Male
Middle Aged
Myocardial Infarction / blood*,  therapy*
Predictive Value of Tests
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Albumins

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