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Background: In the presence of ischaemia, albumin undergoes changes resulting in the formation of ischaemia-modified albumin (IMA). Increased serum concentrations of IMA have been found in patients with myocardial ischaemia. The purpose of this study was threefold: to evaluate the albumin cobalt binding (ACB) assay for measurement of IMA on the Beckman Coulter LX-20; to establish a reference range for IMA; and to investigate the relationship between IMA and total albumin concentrations.    Methods: The ACB assay was evaluated under the following headings: imprecision, accuracy and reliability. A reference range was established on a population of 81 healthy subjects.    Results: The within-batch coefficient of variation (CV) at IMA concentrations of 88, 99 and 120 KU/L were 1.4, 2.0 and 2.5%, respectively. The between-batch CVs at 74, 84 and 123 KU/L were 3.4, 3.3 and 3.0%, respectively. Comparison with the Cobas Mira Plus showed a mean negative bias of 7 KU/L. The 97.5th percentile established on our reference population was 110 KU/L. A significant inverse relationship was found between total serum albumin and IMA concentrations ( r = -0.66, P &lt; 0.0001). Correcting the IMA concentrations for total albumin in our reference population, using a formula devised in this study, yielded a range similar to that of uncorrected IMA.    Conclusions: The ACB assay was found to have acceptable precision and performed very satisfactorily on the Beckman Coulter LX-20. A correction to measured IMA concentrations, to take into account total albumin concentrations, may need to be applied for the proper interpretation of IMA results.

Evaluation of the albumin cobalt binding (ACB®) assay for measurement of ischaemia-modified albumin (IMA®) on the Beckman Coulter LX-20