BACKGROUND: Creatine Kinase isoenzyme(CK-MB) and troponins are unreliable marker of transient myocardial ischemia, when measured in the first 2 to 6 hours after ischemic event. Recently, several studies showed ischemic modified albumin (IMA) could be a new early marker of transient myocardial ischemia than CK-MB and troponins. We investigated the changes of IMA level following transient myocardial ischemia, compared with the changes of CK-MB and Troponin I level.METHODS: We enrolled twenty patients as an ischemia group who underwent percutaneous coronary intervention(PCI) for chronic stable angina. And 17 patients as control group who had a normal coronary angiogram. Blood samples were obtained for IMA, CK-MB and Troponin I before, 15 min, 1 hour, 6 hours and 12 hours after the PCI in ischemia group. In control group, blood samples were obtained before and 15 min after coronary angiography only.RESULTS: The levels of CK-MB and Troponin-I were not changed following PCI compared with basal level. The basal level of IMA was 97.65짹17.2 U/mL in ischemia group and 90.47짹6.6 U/mL in control group. The level of IMA at 15 min was 116.20짹 15.5 U/mL in ischemia group and 103.35짹9.9 U/mL in control group. The change of IMA level at 15 min was statistically significant between groups (p<0.05). The peak elevated IMA level at 15 min return to basal level at around 6 hours.CONCLUSION: Changes of the IMA could be an early sensitive marker of transient myocardial ischemia and may have a role in very early ischemic event.