Ischemia-Modified Albumin Concentrations Should Be Interpreted with Caution in Patients with Low Serum Albumin Concentrations

Objective: Ischemia-modified albumin (IMA®) is a novel marker for assessing cardiac ischaemia. We assessed the relationship between total albumin concentrations and IMA in serum to investigate whether interpretation of IMA was albumin-dependent. Subjects and Methods: 298 serum samples were assayed for total albumin (albumin), using bromcresol purple, and IMA, using an indirect colorimetric assay. Correlations were investigated for the whole data set and for two subgroups, those samples with low albumin (≤34 g/l) and those with albumin within the reference interval. Results: There was a significant (r = –0.888, p < 0.0001) negative correlation between IMA and albumin both over the entire range of albumin concentrations and in the low albumin concentration subgroup (r = –0.85, p < 0.0001); however, there was less significant correlation in the subgroup with albumin within the reference interval (r = –0.37, p < 0.0001). Conclusion: A negative correlation exists between IMA and albumin concentrations; however, there is less significant correlation when albumin is within the reference interval. IMA concentrations determined in patients with albumin concentrations ≤34 g/l should be interpreted with some caution.