In coronary artery by-pass graft surgery, evaluation with ischemia modified albumin levels of myokardial injury

Cardiopulmonary bypass (CPB) operations are used to fulfill the function of the native heart and lungs in cardiovascular surgery (1).In cardiovascular surgery, especially in coronary artery by-pass grafting procedures, injury related to myocardial ischemia-reperfusion might occur and that is a condition which requires early diagnosis and treatment.In daily practice, the most commonly used cardiac enzymes are creatine kinase(CK), creatine kinase myocardial band (CK-MB), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) which are not specific for myocardium and they do not provide us the opportunity for a really early diagnosis now (2).As structural proteins cardiac troponin T (TnT) and troponin I (TNI) are used. The oxygen-binding protein is myoglobulin. Even though creatine kinase (CK) moderate specifity for the myocardial, in ischemia there is no relase into the blood stream (1).Because of cardiac troponins (TNT and TNI) are high specifity for myocardial and in a condition of ischemia the troponins are increased, as also myoglobin is released from the muscle tissue.In recent years; in myocardial ischemia cases, there have been new studies determining of occurance of the changes in the structure of serum albumin during ischemia, which provides a way for a new marker in serum for cardiac ischemia.Ischemia-reperfusion-induced injury of myocardium occurs in hypoxia, such as acidosis, stress factors of free oxygen radicals and distrupted integrity of on the membrane and tissues bring out variation on albumine sturucture and newly occured injured albumine is defined Ischemia Modified Albumine (IMA) (3).As a result of myocardium injury, increase of blood serum albumin concentration is used as an early cardiac indicator. There have been several groups stating IMA sensitiveness for acute coronary syndrome is 82%, and 95% together with EKG and troponin (3).The primary aim of this study is to examine the sensitiveness of myocardial ischemia which can occur in coronary artery bypass graft in perioperative and post-operative periods. The blood levels of ischemia modified albumin (IMA) is compared to other cardiac biochemical ischemia markers which are creatine kinase isoenzyme MB (CKMB) and troponin I.Key words: Ischemia Modified Albumin, Ischemia, Biomarker