SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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Ž Dravinski1 , V Rumenjak1 , G Miličević2 , M Bakula2

11Department of Medical Laboratory Diagnosis and Tasfusiology, Sveti Duh General Hospital Zagreb, Croatia, 22Department of Cardiology, Internal Clinic, Sveti Duh General Hospital Zagreb, Croatia

Myocardial ischemia results from the lack of adequate blood perfusion to the myocytes, leading to a deficiency of oxygen and nutrients. Recently, the reduced binding of Co (II) to serum albumin has been found to be useful in the diagnosis of acute myocardial ischemia. The aim of this study was to assess the value of Co (II)-albumin binding assay in patients with suspected myocardial injury in the setting of an emergency department.
Methods: We evaluated 66 healthy persons (aged 30 – 56 yrs) as the reference group, and 96 consecutive patients (aged 49–82), with the history of non-traumatic acute chest pain, starting less than 6 hrs before admittance to the emergency department, suggesting myocardial ischemia or an acute coronary syndrome. Patients blood samples were tested by standard cardiac disease markers (troponin I, CKMB) (Dimension Expand, Dade Behring) and a Co (II)-albumin binding assay (colorimetric assay with dithiothreitol).
Results: Values in the healthy group were normally distributed: mean value was 0,481 ABSU (absorbance unit), SD 0,071 ABSU, and 95% confidence interval were 0,464–0,499 ABSU. Patients had significant higher assay levels (mean value ± SD): 0,589±0,164 ABSU compared with healthy persons (p < 0,01). The patients with acute myocardial infarction (N=19) had slightly higher assay level 0,597±0,092 ABSU related to patients with other cardiac illness, but the difference was not statistically significant (p>0,05). Utilizing a cutoff values of 0,591 ABSU, selected from ROC analysis, the sensitivity was 94%, the specificity was 50% (for myocardial ischemia), the negative predictive value was 98% and the positive predictive value was 9%.
Comments and conclusion: Results of this study indicate that patients with evidence of myocardial ischemia and acute coronary syndrome have reduced cobalt binding capacity to albumin. We conclude that this assay may prove to be an early and useful biochemical marker of cardiac ischemia.

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