SERUM LEVEL OF ISCHEMIA MODIFIED ALBUMIN AND TOTAL OXIDATIVE STRESS AS A BIOMARKER FOR DIAGNOSIS OF ISCHEMIC HEART DISEASE PRONE TO MYOCARDIAL INFARCTION

Background: Albumin is the most abundant protein in human blood plasma and its level may vary according to age. In neonates, its level is approximately 3.9 g/dl. It decreases to 2.8 g/dl at 9 months of age and increases slowly (3.5 g/dl to 5.5 g/dl) until the adult age. For albumin perform its main functions - to maintain the colloid osmotic pressure of intravascular fluid and to bind several substances in blood plasma such as bilirubin, fatty acid, calcium ion, magnesium ion and various drugs.Objective: To determine the Serum level of Ischemia Modified Albumin and total oxidative stress as a biomarker for diagnosis of ischemic heart disease prone to myocardial infarction.Methodology: This retrospective study was done at the Department of Biochemistry Mohtarma Benazir Bhutto Shaheed medical college Mirpur. The study duration was one year from March 2023 to March 2024. A total of 120 patients were enrolled in our study. Patients were divided into case group and control group. Case group was further categorized as group A, group B and group C. In group A, subjects with diagnosed Ischemic Heart Disease (IHD), in group B, subjects performed PCI and in group C, subjects with diagnosed MI were included. In control group, normal, healthy subjects with same age as matched to case groups were selected for comparison. IMA assayed by using colorimetric method using dithiothreitol (DTT). Troponin-I was determined by using ELISA kit method. Superoxide Dismutase (SOD) and total antioxidant capacity (TAC) were determined by spectrophotometer. To determine triglycerides (TAG), GOD- PAP method on selectra Pro Sa fully automated analyzer was used. Serum total cholesterol was analyzed by Chod-Pap method on selectra Pro Sa fully automated analyzer. Homogeneous enzymatic colorimetric method was used for estimation of high-density lipoprotein (HDL)– cholesterol and direct method was used for low density lipoprotein (LDL)-cholesterol measurement. All the controls were also subjected to measurement of above biochemical parameters along with estimation of serum IMA. Data was analyzed using Statistical Package for Social Sciences (SPSS), version 24.0.  Results: A total of 120 patients were enrolled in our study with 60 in control group and 60 in case group. Statistically significant results were observed for total cholesterol, HDL and LDL (p=˂.05), while results for TAG were insignificant (p=˃0.05). High mean (± SD) values of IMA (u/ml) were observed for group C (96.11 ± 11.09) followed by group B (88 ± 4.99) and group A (83.11 ± 9.66) as compare to control group (23.99 ± 8.84). Statistically significant results were observed for IMA, troponin-I, SOD and TAC between group A, B, C and control group.