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Letters

Predicting cardiac outcomes

Giuseppe Lippi, Martina Montagnana and Gian Cesare Guidi
CMAJ November 08, 2005 173 (10) 1206-1207; DOI: https://doi.org/10.1503/cmaj.1050168
Giuseppe Lippi
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Martina Montagnana
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Gian Cesare Guidi
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Despite substantial advances in the diagnosis of suspected acute coronary syndromes, significant challenges persist.1 Andrew Worster and colleagues recently reported in CMAJ that ischemia-modified albumin (IMA) was a poor predictor of cardiac outcomes in patients with potential cardiac ischemia symptoms.2 The authors tested 2 thresholds for IMA: 85 μ/mL, as suggested by the manufacturer, and 80 μ/mL. It is important to point out, however, that IMA levels vary considerably, even among healthy individuals. Taking these variations into account may improve the predictive characteristics of IMA.

We examined 35 healthy men (age range 25–54 years) recruited from the general public who had not had a myocardial infarction. Using standard laboratory techniques we found that the average resting IMA concentration was 94 μ/mL (97.5% confidence interval 84–104 μ/mL). IMA concentration was significantly and inversely correlated with serum albumin but not with creatinine concentration. Serum IMA concentration was also significantly associated with serum lactate concentration.3 Taking these and other known factors into account may improve the utility of IMA in predicting serious cardiac outcomes.

REFERENCES

  1. 1.↵
    Christenson J, Innes G, McKnight D, et al. Safety and efficiency of emergency department assessment of chest discomfort. CMAJ 2004;170(12):1803-7.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    Worster A, Devereaux PJ, Heels-Ansdell D, et al. Capability of ischemia-modified albumin to predict serious cardiac outcomes in the short term among patients with potential acute coronary syndrome. CMAJ 2005;172(13):1685-90.
    OpenUrlAbstract/FREE Full Text
  3. 3.↵
    Lippi G, Brocco G, Salvagno GL, et al. High-workload endurance training may increase serum ischemia-modified albumin concentrations. Clin Chem Lab Med 2005;43(7):741–4.
    OpenUrlCrossRefPubMed
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Canadian Medical Association Journal: 173 (10)
CMAJ
Vol. 173, Issue 10
8 Nov 2005
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Predicting cardiac outcomes
Giuseppe Lippi, Martina Montagnana, Gian Cesare Guidi
CMAJ Nov 2005, 173 (10) 1206-1207; DOI: 10.1503/cmaj.1050168

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Predicting cardiac outcomes
Giuseppe Lippi, Martina Montagnana, Gian Cesare Guidi
CMAJ Nov 2005, 173 (10) 1206-1207; DOI: 10.1503/cmaj.1050168
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