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Ischemia-Modified Albumin Test

Last updated Sept. 16, 2018

Approved by: Krish Tangella MD, MBA, FCAP

The IMA (Ischemia-Modified Albumin) is used in the context of myocardial ischemia, which occurs during a heart attack.


What are the other Names for this Test? (Equivalent Terms)

  • IMA Test

What is Ischemia-Modified Albumin Test? (Background Information)

  • The IMA (Ischemia-Modified Albumin) is used in the context of myocardial ischemia, which occurs during a heart attack
  • During a heart attack there is a decreased supply of oxygen to the heart resulting in biochemical characteristics of albumin protein molecules. Because of the ischemia (decrease in blood supply to tissue), the protein albumin decreases its ability to bind to metals, such as cobalt
  • A decrease in oxygen supply to the heart results in ischemia, causing chest pains
  • This decrease in ‘binding to the metal’ resulted in an FDA approved test – the IMA Test, for determining the amount of ischemia in the heart. The IMA test is used along with other tests to diagnose heart attacks

What are the Clinical Indications for performing the Ischemia-Modified Albumin Test?

  • The IMA test is performed with other tests, in order to evaluate cardiac function. These tests include troponin, myoglobin, and electrocardiograms
  • These tests together help to evaluate chest pain in an individual and determine, if a chest pain is caused by heart ischemia, or due to variety of other reasons 

How is the Specimen Collected for Ischemia-Modified Albumin Test?

Sample required: Blood

Process: A needle is inserted into a superficial vein to collect the blood sample.

Preparation required: No special preparation is required prior to performing the IMA test.

What is the Significance of the Ischemia-Modified Albumin Test Result?

  • The IMA test should be interpreted in combination with other tests for cardiac function such as troponin, myoglobin, and ECG. Primarily, IMA is helpful in ruling out the possibility of a heart attack
  • In other words if the IMA is within normal limits, other cardiac markers, such as troponin and myoglobin are within normal limits, and no changes are noted in the electrocardiogram, then the chest pain is not likely due to heart attack
  • It is important to know, what the value of the IMA test is, during the first few hours. If the chest pain occurred several hours ago, then a normal IMA test is not useful; since the Ischemia-Modified Albumin may have fallen back to normal levels, after an initial increase owing to chest pain
  • An increased IMA can also occur due to ischemic changes in other parts of the body, such as gastrointestinal tract and skeletal muscle

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

The utility of the Ischemia-Modified Albumin test in assessing chest pains due to heart attack is limited, at present. More data is being collected to determine the validity of using an IMA test as part of a routine panel of cardiac biomarkers.

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

References and Information Sources used for the Article:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Aug. 19, 2013
Last updated: Sept. 16, 2018