Abstract
BackgroundIschemia-modified albumin is an altered serum albumin that forms under conditions of oxidative stress, a state also associated with doxorubicin-induced myocardial injury.ObjectiveThe aim of this study was to better assess diagnostic and prognostic significance of ischemia-modified albumin in patients with breast cancer undergoing doxorubicin chemotherapy.MethodsBlood samples were collected from 152 breast cancer patients before and after each cycle of doxorubicin chemotherapy to measure the serum levels of ischemia-modified albumin, cardiac troponin T and creatine kinase-MB. We also monitored cardiac function during a 12 month follow-up.ResultsThere was a significant difference in ischemia-modified albumin levels before and after each cycle of chemotherapy and the ischemia-modified albumin concentration positively correlated with the cumulative dose of doxorubicin (r = 0.212, P < 0.05). The combination of ischemia-modified albumin with cardiac troponin T and creatine kinase-MB increased the sensitivity to 0.920 and the specificity to 0.830 in the diagnosis of doxorubicin-induced myocardial injury. The optimal cutoff for ischemia-modified albumin concentration was 112.09 U/ml. The rate of change for ischemia-modified albumin levels correlated negatively with the rate of change for left ventricular ejection fraction at one year (r = –0.221, P < 0.05).ConclusionIschemia-modified albumin may be a clinically potential new marker for diagnosing doxorubicin-induced myocardial injury, and is helpful to predict long-term impairment of cardiac function.
Highlights
Doxorubicin (DOX) is an anthracycline antibiotic with strong anticancer activity first extracted from Streptomyces peucetius var. caesius in 1969 [1,2]
We found a normal distribution for the pre-chemotherapy serum Ischemia-modified albumin (IMA) concentration data using the Kolmogorov-Smirnov test
The mean IMA concentration was (59.2 ± standard deviation (SD) 10.9) U/ml (Figure 1). 152 patients received the first cycle of chemotherapy with the DOX dose as 50mg/m2, and 2 patients happened myocardial injury
Summary
Doxorubicin (DOX) is an anthracycline antibiotic with strong anticancer activity first extracted from Streptomyces peucetius var. caesius in 1969 [1,2]. The diagnosis of DOX-induced myocardial injury is based on the symptoms, electrocardiogram (ECG) and cardiac troponin-T (cTnT) and creatine kinase-MB (CK-MB) fraction levels. Objective: The aim of this study was to better assess diagnostic and prognostic significance of ischemia-modified albumin in patients with breast cancer undergoing doxorubicin chemotherapy. Methods: Blood samples were collected from 152 breast cancer patients before and after each cycle of doxorubicin chemotherapy to measure the serum levels of ischemia-modified albumin, cardiac troponin T and creatine kinaseMB. The combination of ischemia-modified albumin with cardiac troponin T and creatine kinase-MB increased the sensitivity to 0.920 and the specificity to 0.830 in the diagnosis of doxorubicin-induced myocardial injury. Conclusion: Ischemia-modified albumin may be a clinically potential new marker for diagnosing doxorubicin-induced myocardial injury, and is helpful to predict long-term impairment of cardiac function
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