European Journal of Cardiovascular Medicine

Ischemia is a common underdiagnosed vascular emergency, which is associated with an adverse prognosis1. It is initiated whenever the arterial flow cannot supply sufficient oxygen resulting to ir- reversible damage and cell death1,2. The clinical assessment is essential for the timely diagnosis and intervention of this disorder2. Yet, no laboratory test for ischemia is available for the diagnosis of this clinically challenging situation2. Ischemia-modified albumin (IMA) is regarded as a new sensitive marker of myocardial ischemia, in contrast to cardiac enzymes which are released when cardiac necrosis occurs3. During an acute isch- emic event, structural changes occur in the amino terminus of albumin, rapidly reducing its capacity to bind transition metal ions and generate a metabolic variant of the albumin referred as IMA4.