This test for IMA (formerly called albumin cobalt binding) is coming out as a hoped for but unproven means to identify acute coronary syndromes which are either atypical or are short of releasing myoglobin or troponin into the serum. It is thought that an oxygen deficit leads to generation of free radicals that activate enzymes that modify the N-terminal sequence of the albumin molecule so that it does not bind metals well. It is hoped that IMA's negative predictive value will allow patients with typical or atypical symptoms, a normal EKG, and a normal IMA value to abort further cardiac workup.

As of 8/05, our lab has seen no solid reason to either add the IMA to our profile or to substitute it for myoglobin. 

References:

1. CAP Today, March 2002 via CAP website

2. CAP Today, July or August 2005 via CAP website

3. colleague's expert opinion 8/2005.

(posted 2002; latest note 7 August 2005)