|
FDA CLEARANCE RECEIVED TO MARKET ISCHEMIA MODIFIED ALBUMIN (IMA)
DENVER, February 14, 2003 Ischemia Technologies, Inc. announced today that
it has received US Food and Drug Administration (FDA) clearance to market the Albumin
Cobalt Binding (ACB®) test for detection of Ischemia Modified Albumin (IMATM).
IMA is a serum biomarker that can be used as an aid to the early evaluation of acute
coronary syndromes (ACS) prior to heart attack in patients presenting with chest pain
suggestive of cardiac origin. The ACB test uses a small amount of blood drawn from
a patient, which is then run on a chemistry instrument commonly available in hospital
laboratories.
Chest pain is the second most common reason for visiting an emergency department
(ED) in the United States, prompting 6 million patient visits each year. Only about
one in five patients with chest pain will ultimately be diagnosed with ACS. The challenge
for emergency physicians is to determine which patients have ACS, and which can be
safely discharged home. Currently available tests such as electrocardiography (ECG)
and other biomarkers such as troponin are limited in their impact on making "rule-out"
decisions in the ED. This decision process often takes from 8 to 24 hours, and costs
Medicare and private insurance companies thousands of dollars per visit.
"The availability of a new, highly sensitive, serum marker for myocardial ischemia
will have significant impact on clinical practice in the emergency department,"
stated Charles Pollack, MD, chairman of the emergency department at Pennsylvania Hospital
and associate professor at the University of Pennsylvania, and a clinical investigator
of IMA. "For the majority of chest pain patients we see in the ED, the ECG and
other tests like troponin do not help. IMA results will help direct the use of both
diagnostic and therapeutic resources in a more cost-effective and risk-appropriate
fashion. When used properly, IMA could significantly shorten ED lengths of stay and
reduce expense for low-risk patients."
"For several years, the clinical community has been looking for a reliable,
inexpensive test to determine which chest pain patients can be sent home safely,"
explained Robert Jesse, MD, PhD, associate professor of cardiology at the Medical
College of Virginia, which was one of twenty research sites involved in clinical studies
of IMA. "Studies showed that IMA, when used in conjunction with ECG and troponin,
correctly identified low-risk patients who could be discharged safely using test results
from patient presentation, without the need for more extensive testing in the ED."
"FDA clearance is a great achievement for our company, and is the culmination
of over a decade of scientific research and development on IMA," noted Peter
Crosby, president and CEO of Ischemia Technologies. "In developing this test,
we have been fortunate to have advising us many of the leading chest pain researchers
and physicians worldwide. These experts have suggested guidelines for how best to
use IMA to assist clinical decision-making by emergency physicians. We are also grateful
for the tremendous involvement of the FDA."
The emergency physician currently has three diagnostic tools available at the time
a patient presents to help assess the likelihood of ACS: 1) ECG, which measures electrical
activity of the heart; 2) biomarkers of cardiac necrosis (troponin, CKMB, myoglobin),
and 3) history and physical exam, to observe physical condition and identify cardiac
risk factors such as obesity, smoking, family history, and diabetes.
Using these tools at patient presentation, the emergency physician can typically
diagnose 12 percent of patients based on diagnostic ECG or elevated markers of necrosis.
Another 13 percent can be considered for discharge based on history and physical findings.
This leaves about 75 percent of patients in a "grey zone", in which the
emergency physician must weigh the trade-offs of accelerating treatment versus "watchful
waiting" and additional diagnostic testing. IMA adds a fourth diagnostic tool,
which may assist emergency physicians to "rule out" ACS in low risk patients.
With IMA, up to 40 percent of chest pain patients could be safely discharged within
a few hours.
EDITOR'S NOTES
Ischemia Modified Albumin
IMA was first identified by an emergency physician seeking a rapid, reliable blood
test for ischemia. Differences in blood samples between apparently healthy volunteers
and ischemic patients were found to be due to changes in albumin, the most common
protein in blood. IMA is produced when albumin circulating in blood comes in contact
with ischemic tissue in the heart or other organ. During ischemia, a series of chemical
reactions occur that modify albumin, resulting in Ischemia Modified Albumin. IMA is
produced continually during ischemia, which means IMA levels in blood change quickly.
Patients at low risk for ACS have proportionately less IMA than patients at high risk
or with confirmed ACS.
Acute Coronary Syndrome
Acute coronary syndrome (ACS) is the medical term for the constellation of clinical
signs, symptoms and test results suggestive of a range of pathology from ischemia
to acute myocardial infarction. The most common symptom is discomfort in the center
of the chest (angina pectoris). Other symptoms may include pain in the arms, back
or jaw, shortness of breath, and sweating, nausea or lightheadedness. ACS results
from lack of oxygen to heart muscle, usually as a result of blocked coronary arteries
that deliver oxygenated blood to the heart.
Ischemia (is-`kÂ-mÂ-ah) is an imbalance between oxygen supply and demand,
usually caused by clogged arteries, that leads to insufficient oxygen to tissues such
as the heart. Cardiac ischemia, which includes ACS, is the most common form. Other
forms of ischemia include cerebral, bowel and muscle.
Myocardial infarction (MI) or heart attack, occurs when prolonged ischemia leads
to death (necrosis) of heart muscle. The area of dead heart muscle is called an infarct.
The transition from reversible ischemia to irreversible ischemia to infarct is referred
to as an evolving or Acute Myocardial Infarction (AMI).
About Ischemia Technologies
Ischemia Technologies develops, manufactures and markets new and unique in vitro diagnostic
products with a focus on cardiovascular and acute care medicine. Located in Denver,
Colorado, the company is financed by equity investments from strategic partners, venture
capitalists and private equity investors. The company is certified to the international
quality standards ISO 9001, ISO 13485 and EN 46001. Additional information can be
found at www.ischemia.com.
|