Effect of deep vein thrombosis on ischaemia-modified albumin levels.

BACKGROUND: An increasing number of studies have shown that ischaemia-modified albumin (IMA) levels rise in a number of acute ischaemic conditions such as cerebral infarct, myocardial infarct, pulmonary infarct and mesenteric infarct, suggesting that IMA may be useful as a diagnostic marker. A study was undertaken to investigate the effect on IMA levels of deep vein thrombosis (DVT), frequently encountered at the outset or during the course of diseases such as pulmonary embolism and cerebral infarct. METHODS: A case-control study was performed in the emergency department of Karadeniz Technical University Hospital, Turkey. 41 patients presenting to the emergency and vascular surgery departments and definitively diagnosed with DVT using Doppler ultrasonography were enrolled in the study. A control group of 66 age-matched healthy volunteers served as a reference for biochemical parameters. RESULTS: Mean (SD) plasma IMA levels were 0.259 (0.066) absorbance units (ABSU) in the DVT group and 0.171 (0.045) ABSU in the control group (p<0.005). The area under the curve for IMA was 0.850 (95% CI 0.768 to 0.933). The IMA value with acceptable sensitivity and specificity capable of being raised was 0.195 ABSU (sensitivity 80.5%, specificity 71.2%). CONCLUSIONS: DVT is associated with raised serum IMA levels but IMA levels are not suitable as a diagnostic marker for DVT.

Serum ischaemia-modified albumin increases in critical lower limb ischaemia.

BACKGROUND: Ischaemia is a common phenomenon in the pathogenesis of a wide range of medical and surgical conditions, including myocardial infarction, mesenteric vascular occlusion and compartment syndrome. Ischaemia modified albumin has been suggested as an aid to clinical decision making in various clinical settings. This study examines the usefulness of IMA in the diagnosis of limb ischaemia (LI). METHODS: This case-controlled study was performed in the emergency department of Karadeniz Technical University Hospital, Turkey. 22 patients presenting to the emergency departments and definitively diagnosed with LI were enrolled in the study. A control group of 22 healthy volunteers served as a reference for biochemical parameters. RESULTS: The mean serum IMA level for LI patients was 0.295 (SD 0.062) ABSU. The mean serum IMA level for control patients was 0.174 (SD 0.061) ABSU. There was a statistically significant difference between the mean LI patient and mean control patient IMA levels (p<0.0005). A ROC curve analysis reveals the relationship between sensitivity and specificity for IMA in limb ischaemia. CONCLUSION: There is a significant increase in serum IMA in limb ischaemia. Furthermore, using a cutoff of 0.22 ABSU, ROC curve analysis shows that IMA is 81.8% sensitive and 81.8% specific 81.8% in patients with clinically severe lower limb ischaemia. Future studies would be needed to determine if IMA would be clinically useful in the diagnosis of subtle limb ischaemia.