Background and Purpose: Stroke is one of the leading causes of mortality and long-term disability. Prompt diagnosis and treatment of stroke are crucial for a better outcome. A blood test, which serves as a biomarker in rural areas will help in immediately transferring patients to a hospital for thrombolytic therapy. The aim of the present study was to examine the role of ischemia modified albumin (IMA) as a screening biomarker in acute ischaemic stroke. Materials and Methods: Serum samples were collected from 50 patients with acute ischaemic stroke within one, 24, 48, 72 and 144 h of time of admission for IMA. We compared patients’ 1st-hour value with age- and sex-matched controls by independent sample t test. p value < 0.05 was considered significant. Results: The serum IMA levels of patients 1st hour (108 ± 8.9) were significantly higher than those of the controls (79 ± 6.3) p < 0.05. The IMA levels showed a steady decline at 1 h (108 ± 8.9), 24 h (94 ± 4.2), 48 h (82 ± 6.1), 72 h (77 ± 5.6) and 144 h (76 ± 3.8) of admission in patients. Conclusion: We observed that serum IMA was significantly higher in stroke patients as compared to controls. IMA was elevated in the acute phase of stroke and had a gradual graded decline over 1 week. We concluded that IMA may be a sensitive and rapid biomarker for screening of early ischaemic stroke in rural settings.

1.
Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al: Heart disease and stroke statistics–2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008; 119: 489–486.
2.
Kim MH, Kang SY, Kim MC, Lee WI: Plasma biomarkers in the diagnosis of acute ischemic stroke. Ann Clin Lab Sci 2010; 40: 336–341.
3.
Cuzzocrea S, Riley DP, Caputi AP, Salvemini D: Antioxidant therapy: a new pharmacological approach in shock, inflammation, and ischemia/reperfusion injury. Pharmacol Rev 2001; 53: 135–159.
4.
Bar-Or D, Lau E, Winkler JV: A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med 2000; 19: 311–315.
5.
Sinha MK, Roy D, Gaze DC, Collinson PO, Kaski JC: Role of IMA, a new biochemical marker of myocardial ischeamia, in the early diagnosis of acute coronary syndromes. Emerg Med J 2004; 21: 29–34.
6.
Nayak AR, Kashyap RS, Kabra D, Purohit HJ, Taori GM, Daginawala HF: Prognostic significance of ischemia-modified albumin in acute ischemic stroke patients: a preliminary study. Ann Neurosci 2011; 18: 5–7.
7.
Bamford J, Sandercock P, Dennis M, Burn J, Warlow C: Classification and natural history of clinically identifiable subtypes of -cerebral infarction. Lancet 1991; 337: 1521–1526.
8.
National Institute of Health, National Institute of Neurological Disorders and Stroke. Stroke Scale. http://www.ninds.nih.gov/doctors/NIH_Stroke_Scale.
9.
Chan B, Dodsworth N, Woodrow J, Tucker A, Harris R: Site-specific N-terminal auto-degradation of human serum albumin. Eur J Biochem 1995; 227: 524–528.
10.
Hlatky MA: Exercise testing to predict outcome in patients with angina. J Gen Intern Med 1999; 14: 63–65.
11.
Gunduz A, Turedi S, Mentese A, et al: Ischemia-modified albumin levels in cerebrovascular accidents. Am J Emerg Med 2008; 26: 874–878.
12.
McCord JM: Oxygen-derived free radicals in postischemic tissue injury. N Engl J Med 1985; 312: 159–163.
13.
Gutierrez-Correa J, Stoppani AO: Inactivation of yeast glutathione reductase by Fenton systems: effect of metal chelators, catecholamines and thiol compounds. Free Radic Res 1997; 27: 543–555.
14.
Lippi G, Montagnana M: Ischemia-modified albumin in ischemic disorders. Ann Thorac Cardiovasc Surg 2009; 15: 137.
15.
Senes M, Kazan N, Coskun O, Zengi O, Inan L, Yücel D: Oxidative and nitrosative stress in acute ischaemic stroke. Ann Clin Biochem 2007; 44: 43–47.
16.
Can M, Demirtas S, Polat O, Yildiz A: Evaluation of effects of ischaemia on the albumin cobalt binding (ACB) assay in patients exposed to trauma. Emerg Med J 2006; 23: 537–539.
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