This variant form of albumin is called ischemia-modified albumin (IMA), which reflects the cobalt-binding capacity of albumin.10 IMA has emerged as a useful biochemical marker in the diagnosis of myocardial ischemia,11 and elevated IMA levels are related to a number of clinical conditions, such as type 2 diabetes,12 metabolic syndrome,13 cancer14, and chronic kidney disease.15 Here, ALB is linked to myocardial ischemia.