Interventional CardiologyReduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: A preliminary comparison to creatine kinase-MB, myoglobin, and troponin I☆,☆☆,★
Section snippets
Methods
In this prospective study, 42 patients without evidence for acute myocardial infarction scheduled for elective PTCA and 13 control patients scheduled for elective diagnostic coronary angiography were enrolled at two hospitals: Swedish Medical Center, Englewood, Colo, and Centura Health Porter Adventist Hospital, Denver, Colo. Institutional review boards of both hospitals approved the study protocol, and all patients gave informed consent. Patients were excluded if they had any of the following:
Study group patient characteristics
Study group clinical characteristics are represented in Table I.The PTCA study group of 41 patients included 26 (63%) men and 15 (37%) women; the mean age was 62.8 years (range, 41 to 83), with 30 (73%) of 41 having ≥2 risk factors for coronary artery disease, 10 (24%) of 41 having unstable angina, and 20 (49%) of 41 having had a prior revascularization procedure (Table II).A high percentage of study group patients (33 [81%] of 41) had at least one of the following signs of myocardial ischemia
Discussion
This preliminary study is the first to report significantly reduced exogenous cobalt binding to the Nterminus of human albumin after transient arterial occlusion and reperfusion with PTCA. These data suggest that alterations of ACB, compared with baseline, occur within minutes after PTCA-induced ischemic changes and can be detected by elevated values of a new colorimetric ACB assay.9 Additionally, the results indicate that elevated ACB assay levels return to baseline within 6 hours after PTCA.
Acknowledgements
We thank Andrea van Woudenberg, JoBeth Northrop, RN, and Deborah L. Morris, MS, for their assistance in the preparation of the manuscript.
References (28)
- et al.
An emergency department-based protocol for rapidly ruling out myocardial ischemia reduces hospital time and expense: results of a randomized study (ROMIO)
J Am Coll Cardiol
(1996) - et al.
Diagnostic accuracy of myoglobin concentration for the early diagnosis of acute myocardial infarction
Ann Emerg Med
(2000) - et al.
Prediction of short- and long-term outcomes by troponin T levels in low-risk patients evaluated for acute coronary syndromes
Ann Emerg Med
(2000) - et al.
A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia: a preliminary report
J Emerg Med
(2000) - et al.
Patterns of mobilization of copper and iron following myocardial ischemia: possible predictive criteria for tissue injury
J Mol Cell Cardiol
(1997) - et al.
Twelve-lead electrocardiographic evaluation of ischemia during percutaneous transluminal coronary angioplasty and its correlation with acute reocclusion
Am Heart J
(1991) - et al.
Relation of minor cardiac troponin I elevation to late cardiac events after uncomplicated elective successful percutaneous transluminal coronary angioplasty for angina pectoris
Am J Cardiol
(1999) - et al.
Validation of continuous radionuclide left ventricular functioning monitoring in detecting silent myocardial ischemia during balloon angioplasty of the left anterior descending coronary artery
Am J Cardiol
(1991) - et al.
Cardiac troponin T and CK-MB mass release after visually successful percutaneous transluminal coronary angioplasty in stable angina pectoris
Am Heart J
(1994) - et al.
Role of coronary collateral vessels during transient coronary occlusion during angioplasty assessed by hemodynamic, electrocardiographic and metabolic changes
J Am Coll Cardiol
(1988)
Adaptation to myocardial ischemia during coronary angioplasty demonstrated by clinical, electrocardiographic, echocardiographic, and metabolic parameters
Am Heart J
The time of onset and severity of acidosis in myocardial ischaemia
J Mol Cell Cardiol
Albumin: an important extracellular antioxidant?
Biochem Pharmacol
Effect of duration from symptom onset on the negative predictive value of a normal ECG for exclusion of acute myocardial infarction
Ann Emerg Med
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Supported by DMI BioSciences, Inc, Englewood, Colo, and Ischemia Technologies, Inc, Denver, Colo.
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David Bar-Or, Edward Lau, and James V. Winkler are employees of DMI BioSciences, Inc, and own stock in the company.
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Reprint requests: David Bar-Or, MD, DMI BioSciences, Inc, 3601 S Clarkson, #335, Englewood, CO 80110-3944. E-mail: [email protected]