Role of Ischemia Modified Albumin in Diagnosis of Pulmonary Embolism


Pulmonary embolism is a common and potentially lethal condition. Clinical signs and symptoms for pulmonary
embolism are nonspecific. New and simple tests are therefore needed in order to help in early diagnosis of pulmonary embolism. The aim of this work is to elucidate the role of IMA in the diagnosis of pulmonary embolism. Subjects and Methods: 75 patients with suspected pulmonary embolism and 20 control healthy subjects were included in this study. Measurement of IMA was done in all subjects. Results: The mean values of IMA were statistically significantly higher among the PE patient group (0.43 ± 0.104 ABSU) in comparison with non PE patient group (0.27 ± 0.053 ABSU) and healthy control subjects (0.21 ± 0.080 ABSU). At cut-off value of 0.305 ABSU, IMA had 97.5% sensitivity and 71.42% specificity. The area under the curve was 0.952. The positive predictive value of this cut-off value was 79.59% while the negative predictive value was 96.15%. Conclusions: IMA is a good alternative to D-dimer in the diagnosis and exclusion of PE. Larger studies are needed to augment our results.

Share and Cite:

A. Halim, A. Attia, S. Samra, T. Zytoun, H. Salah and M. Al-Anazi, "Role of Ischemia Modified Albumin in Diagnosis of Pulmonary Embolism," Open Journal of Respiratory Diseases, Vol. 4 No. 1, 2014, pp. 22-26. doi: 10.4236/ojrd.2014.41004.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] S. Ozsu, F. Oztuna, Y. Bulbul, et al. “The Role of Risk Factors in Delayed Diagnosis of Pulmonary Embolism,” American Journal of Emergency Medicine, Vol. 29, No. 1, 2011, pp. 26-32.
[2] V. F. Tapson, “Acute Pulmonary Embolism,” The New England Journal of Medicine, Vol. 358, No. 10, 2008, pp. 1037-1052.
[3] D. C. Gaze, “Ischemia Modified Albumin: A Novel Biomarker for the Detection of Cardiac Ischemia,” Drug Metabolism and Pharmacokinetics, Vol. 24, No. 4, 2009, pp. 333-341.
[4] B. S. Hausen, C. Signor, H. Kober, E. Tatsch, R. S. Pereira, T. Duarte, C. L. Hermes, M. M. Duarte and R. N. Moresco, “Effect of Temperature on Albumin Cobalt Binding and Its Influence on Ischemia-Modified Albumin Levels in Patients with Suspected Acute Coronary Syndrome,” Clinical Laboratory, Vol. 58, No. 1-2, 2012, pp. 169-172.
[5] K. Han, N. Jia, L. Yang and L. Q. Min, “Correlation between Ischemia-Modified Albumin and Lipid Levels in Patients with Acute Cerebrovascular Disease,” Molecular Medicine Reports, Vol. 6, No. 3, 2012, pp. 621-624.
[6] M. Uygun, S. Yilmaz, M. Pekdemir, C. Duman and Y. S. Gürbüz, “The Diagnostic Value of Ischemia-Modified Albumin in a Rat Model of Acute Mesenteric Ischemia,” Academic Emergency Medicine, Vol. 18, No. 4, 2011, pp. 355-359.
[7] K. Maneewong, T. Mekrungruang-wong, S. Luangaram, T. Thongsri and S. Kumphune, “Combinatorial Determination of Ischemia Modified Albumin and Protein Carbonyl in the Diagnosis of NonST-Elevation Myocardial Infarction,” Indian Journal of Clinical Biochemistry, Vol. 26, No. 4, 2011, pp. 389-395.
[8] E. Kountana, K. Tziomalos, P. Semertzidis, F. Dogrammatzi, A. Slavakis, S. Douma, C. Zamboulis and P. Geleris, “Comparison of the Diagnostic Accuracy of Ischemia-Modified Albumin and Echocardiography in Patients with Acute Chest Pain,” Experimental & Clinical Cardiology, Vol. 18, No. 2, 2013, pp. 98-100.
[9] A. Toker, A. Aribas, F. H. Yerlikaya, E. Tasyurek and K. Akbuga, “Serum and Saliva Levels of Ischemia-Modified Albumin in Patients with Acute Myocardial Infarction,” Journal of Clinical Laboratory Analysis, Vol. 27, No. 2, 2013, pp. 99-104.
[10] W. Ghanima, M. Abdelnoor, M. C. Mowinckel and P. M. Sandset, “The Performance of STA-Liatest D-Dimer Assay in Out-Patients with Suspected Pulmonary Embolism,” British Journal of Haematology, Vol. 132, No. 2, 2006, pp. 210-215.
[11] D. Bar-Or, E. Lau and J. Winker, “A Novel Assay for Cobalt-Albumin Binding and It’s Potential as a Marker Formyocardial Ischemia—A Preliminary Report,” The Journal of Emergency Medicine, Vol. 19, No. 4, 2000, pp. 311-315.
[12] A. van Belle, H. R. Buller, M. V. Huisman, P. M. Huisman, K. Kaasjager, P. W. Kamphuisen, M. H. Kramer, M. J. Kruip, J. M. Kwakkel-van Erp, F. W. Leebeek, M. Nijkeuter, M. H. Prins, M. Sohne and L. W. Tick, “Effectiveness of Managing Suspected Pulmonary Embolism Using an Algorithm Combining Clinical Probability, D-Dimer Testing, and Computed Tomography,” JAMA, Vol. 295, No. 2, 2006, pp. 172-179.
[13] V. King, A. A. Vaze, C. S. Moskowitz, L. J. Smith and M. S. Ginsberg, “D-Dimer Assay to Exclude Pulmonary Embolism in High Risk Oncologic Population: Correlation with CT Pulmonaryangiography in an Urgent Care Setting,” Radiology, Vol. 247, No. 3, 2008, pp. 854-861.
[14] T. Walter, P. Apfaltrer, F. Weilbacher, M. Meyer, S. O. Schoenberg, C. Fink and J. Gruettner, “Predictive Value of High-Sensitivity Troponin I and D-Dimer Assays for Adverse Outcome in Patients with Acute Pulmonary Embolism,” Experimental and Therapeutic Medicine, Vol. 5, No. 2, 2013, pp. 586-590.
[15] S. F. Alnomasy, S. Ansari, M. A. Izhari, S. Alam and S. Ali, “Evaluation of D-Dimer Level among Adult Patients in Al-Quwayyah Government Hospital, Saudi Arabia,” Journal of Applied Pharmaceutical Science, Vol. 2, No. 12, 2012, pp. 82-84.
[16] S. Turedi, A. Gunduz, A. Mentese, M. Topbas, S. C. Karahan, S. Yeniocak, I. Turan, O. Eroglu, U. Ucar, Y. Karaca, S. Turkmen and R. M. Russell, “The value of Ischemia-Modified Albumin Compared with D-Dimer in the Diagnosis of Pulmonary Embolism,” Respiratory Research, Vol. 30, No. 9, 2008, p. 49.
[17] G. Waser, S. Kathriner and W. A. Wuillemin, “Performance of the Automated and Rapid STA Liatest D-Dimer on the STA-R Analyzer,” Thrombosis Research, Vol. 116, No. 2, 2005, pp. 165-170.
[18] S. Turedi, A. Gunduz, A. Mentese, S. C. Karahan, S. E. Yilmaz, O. Eroglu, I. Nuhoglu, I. Turan and M. Topbas, “The Value of Ischemia-Modified Albumin in the Diagnosis of Pulmonary Embolism,” American Journal of Emergency Medicine, Vol. 25, No. 7, 2007, pp. 770-773.
[19] L. B. Zheng, Z. Q. Wang, Z. Wang, M. Peng, J. T. Zhang, Z. He and L. G. Shi, “The Application of Ischemia Modified Albumin in the Diagnosis of Acute Pulmonary Embolism,” Journal of Clinical Cardiology, Vol. 9, No. 1, 2010, pp. 100-105.
[20] K. Hogg, E. Hinchliffe, S. Halsam, A. Valkov and F. Lecky, “Is Ischaemia-Modified Albumin a Test for Venous Thromboembolism?” Emergency Medicine Journal, Vol. 29, No. 6, 2012, pp. 455-459.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.