Document Detail

Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: a preliminary comparison to creatine kinase-MB, myoglobin, and troponin I.
MedLine Citation:
PMID:  11376314     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Previous reports suggest that ischemic conditions rapidly reduce the capacity of human albumin to bind exogenous cobalt. A new assay based on human albumin-cobalt binding (ACB) may help detect early myocardial ischemia. We investigated altered ACB during the first 24 hours after transient ischemia induced during elective percutaneous transluminal coronary angioplasty (PTCA). We then compared ACB assay results with creatine kinase isoenzyme (CK-MB), myoglobin, and cardiac troponin I (cTn-I) values after PTCA. METHODS AND RESULTS: In 41 patients undergoing elective PTCA, plasma samples were tested for the ACB assay, CK-MB, myoglobin, and cTn-I before, immediately after, and 6 and 24 hours after PTCA. Thirteen additional patients served as a control group with albumin-cobalt assays performed before and after diagnostic coronary catheterization without angioplasty. ACB assay results demonstrated a significant mean percent difference (10.1%) immediately after PTCA compared with baseline (P < .000001) and returned to baseline by 6 hours after PTCA. ACB assay differences immediately after PTCA were significantly greater than in the control group (10.1% vs -0.9%, P < .001). Mean CK-MB, myoglobin, and cTn-I values were not elevated above baseline immediately after PTCA but were significantly elevated above baseline 6 and 24 hours after PTCA. CONCLUSIONS: These preliminary results suggest that human albumin undergoes a significant reduction in its capacity to bind exogenous cobalt soon after transient coronary occlusion during human PTCA and before significant elevations of CK-MB, myoglobin, or cTn-I. Further confirmatory investigations are warranted to determine if the ACB assay is a useful diagnostic test for early myocardial ischemia.
D Bar-Or; J V Winkler; K Vanbenthuysen; L Harris; E Lau; F W Hetzel
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  141     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-05-28     Completed Date:  2001-06-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  985-91     Citation Subset:  AIM; IM    
Swedish Medical Center.
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MeSH Terms
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary*
Biological Markers / blood*
Case-Control Studies
Cobalt / diagnostic use*,  metabolism
Creatine Kinase / blood
Creatine Kinase, MB Form
Isoenzymes / blood
Middle Aged
Myocardial Ischemia / diagnosis*,  therapy*
Myoglobin / blood
Postoperative Period
Prospective Studies
Protein Binding
Serum Albumin / diagnostic use*,  metabolism
Troponin I / blood
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Myoglobin; 0/Serum Albumin; 0/Troponin I; 7440-48-4/Cobalt; EC Kinase; EC Kinase, MB Form

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