European Journal of Cardiovascular Medicine

Introduction: Acute stroke is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular cause which may be either ischemic or hemorrhagic in nature. Acute ischemic stroke, most common of the two types, results from prolonged cerebral ischemia leading to cerebral neuronal death. Ischemia Modified Albumin (IMA) is the only ischemic marker which has been approved by Food and Drug Administration(FDA) of United States(US) for early diagnosis of myocardial ischemia. Serum IMA levels and IMA to Albumin ratio(IMAR) were shown to increase in several diseases such as myocardial ischemia, acute stroke, muscle ischemia and bowel ischemia. Aim and Objectives: The aim of the study is to know whether Ischemia Modified Albumin (IMA) level is elevated in acute stroke patients and to compare the IMA levels and IMA to albumin ratio (IMAR) in acute stroke patients with healthy controls. Materials and Methods: Data required for the study were extracted from confirmed cases of Acute stroke (Diagnosed clinically and radiologically) patients attending Emergency and Intensive Care Unit of Neurology Department, GGH, Guntur and age matched normal healthy persons taken as controls. Biochemical parameters for the study were Ischemia Modified Albumin (IMA) estimated by Albumin Cobalt binding method and serum Albumin estimated by Bromo Cresol Green Dye binding method done on Beckman Coulter, Au 480 fully automated biochemistry analyzer. Ischemia Modified Albumin to Albumin Ratio(IMAR) was calculated from the results of both test and control groups. Results: IMA values of acute stroke patients were significantly higher than the control group (P Value <0.001). Mean serum albumin value of control group was higher than that of acute stroke patients. Negative Correlation was seen in Stroke patients between Serum Albumin and IMA (r = - 0.876). Mean IMA to Albumin Ratio(IMAR) of acute stroke patients were significantly higher than the control group (P Value <0.001). Conclusion: Ischemia Modified Albumin(IMA)would be a novel biomarker to support the clinical diagnosis of acute stroke. n this study mean IMA values of Acute Stroke patients were significantly higher than the control group. An arbitrary cut-off of 105.17 U/ml of IMA was chosen based on the ROC Curve analysis in the diagnosis of Acute Stroke patients. Further large scale studies are needed to choose clinically appropriate cut–off for serum IMA levels.