A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia—a preliminary report

We initially observed a phenomenon of reduced in vitro binding of exogenous cobalt [Co(II)] to the N-terminus of human serum albumin (HSA) in emergency chest pain patients with early onset unstable angina and myocardial infarction. We then developed a colorimetric assay to measure cobalt-HSA binding...

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Bibliographic Details
Published in:The Journal of emergency medicine 2000-11, Vol.19 (4), p.311-315
Main Authors: Bar–Or, David, Lau, Edward, Winkler, James V
Format: Article
Language:English
Subjects:
Aged
Binding Sites
Biological and medical sciences
Biomarkers - blood
Cardiology. Vascular system
Case-Control Studies
chest pain
Chest Pain - blood
Chest Pain - diagnosis
Chest Pain - etiology
cobalt
Cobalt - metabolism
Colorimetry - methods
Coronary heart disease
Decision Trees
diagnostic assay
Emergency Treatment - methods
Female
Heart
human serum albumin
Humans
Male
Mass Screening - methods
Medical sciences
Middle Aged
myocardial ischemia
Myocardial Ischemia - blood
Myocardial Ischemia - complications
Myocardial Ischemia - diagnosis
Prospective Studies
Sensitivity and Specificity
Serum Albumin
Time Factors
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Summary:We initially observed a phenomenon of reduced in vitro binding of exogenous cobalt [Co(II)] to the N-terminus of human serum albumin (HSA) in emergency chest pain patients with early onset unstable angina and myocardial infarction. We then developed a colorimetric assay to measure cobalt-HSA binding and record the results in absorbance units (ABSU). In a preliminary clinical study of 139 emergency patients with acute chest pain, 99 patients with evidence of myocardial ischemia (Group 1) had elevated assay levels (mean ABSU ± SD; 0.519 ± 0.086) compared to 40 patients (Group 2) with no evidence of ischemia (0.316 ± 0.092) (p < 0.00001). In Group 1, 95 of 99 (96.0%) patients had levels higher than a decision threshold of 0.400 ABSU and in Group 2, 37 of 40 (92.5%) samples had higher cobalt binding capacity (ABSU ≤ 0.400). Further studies are warranted to determine if an assay measuring altered cobalt-HSA binding is a clinically useful diagnostic test to rule out myocardial ischemia.
ISSN:0736-4679
2352-5029
DOI:10.1016/S0736-4679(00)00255-9