A Study of Diagnostic Utility of Ischemia Modified Albumin in Cerebrovascular Accidents

Background: The absence of a widely available and sensitive diagnostic test, acute cerebral ischemia remains a significant limitation in the diagnosis and management of stroke. Computed Tomography (CT) scanning and MRI are may be normal in early phase or not feasible every time in developing country like India. Ischemia Modified Albumin (IMA) is a marker for ischemia. Pathophysiology of stroke also involved ischemia. Hence objective of this study is to evaluate diagnostic utility of IMA in cerebro-vascular stroke. Method: This cross sectional type of study consists of 100 subjects, 35 ischemic stroke, 15 hemorrhagic stroke (definitive diagnosis based on radiological images) and 50 as control. Blood samples obtained within 6 hours of presentation were analysed for IMA by albumin cobalt binding assay. Result: IMA concentrations were 0.410 ± 0.0478 absorbance unit (ABSU) in ischemic stroke, 0.319 ± 0.0632 ABSU in hemorrhagic stroke and 0.240 ± 0.0363 ABSU in control group. IMA concentrations were statistically higher (p 18 years (36 male and 14 female) admitted in medical / surgical ICU within 6 hours of clinical and/or radiological evidence of Cerebrovascular accident, were recruited in the study. Definitive diagnosis of stroke and its classification is based on radiological study (CT scan or MRI) and 15 hemorrhagic strokes and 35 ischemic strokes were confirmed. Control group: 50 age and sex matched normal individuals, who don’t have any evidence of ischemic disease per se clinical examination, come to the hospital for routine whole body health check-up were included in control group. Exclusion criteria: Any patient with history suggestive of other ischemic diseases like acute coronary syndrome, acute myocardial infraction, pulmonary embolism or peripheral vascular diseases was excluded from this study. Patient with liver diseases (serum albumin level 5.5gm/dl) and/or renal failure (serum creatinine level > 1.7mg/dl) was also excluded.