Background: In the emergency department (ED), the diagnosis of acute myocardial ischaemia is very difficult because of the absence of a rapid, reliable diagnostic test. The albumin cobalt binding (ACB) assay is a good candidate as a marker for for detection of myocardial ischaemia, as it is an easy and rapid test. To date, however, the way in which alterations in metal binding sites of human serum albumin depend on ischaemic events has not been reported in detail.
Methods: We studied 92 patients admitted to the ED within 1 hour after exposure to trauma. Trauma patients divided into two groups according to their Injury Severity Score (ISS): group 1 comprised mildly injured patients who had ISS trauma score <15 (n = 60), and group 2 comprised moderately injured patients with ISS trauma score >15 (n = 32). The blood specimens of 30 healthy volunteers were studied as a control group.
Results: Group 2 showed significantly increased ACB levels (0.63 (0.18) absorbance units (ABSU)) compared with group 1 (0.54 (0.14) ABSU) (p<0.05) and controls (0.39 (0.05) ABSU) (p<0.01). Group 1 showed significantly enhanced ACB values compared with controls (0.54 (0.14) v 0.39 (0.05) ABSU) (p<0.01).
Conclusion: Consequently, trauma enhances ACB levels, which may affect the diagnostic performance of the ACB assay, and this effect can limit the ability of the assay for detection of myocardial ischaemia in patients exposed to trauma.
- ABSU, absorbance units
- AST, aspartate aminotransferase
- CK, creatine phosphokinase
- cTn1, cardiac troponin I
- ED, emergency department
- HSA, human serum albumin
- ISS, Injury Severity Score
- LDH, lactate dehydrogenase
- albumin cobalt binding (ACB) assay
- myocardial ischaemia
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Competing interestst: there are no competing interests.