Problem statement: The evaluation of myocardial protection during on-pump cardiac operations is of great importance. Creatinin kinase, cardiac troponin I, myoglobin, fatty-acid-binding proteins are well known markers for investigation of ischemia (1). Ischemia modified albumin is a reliable, new marker in cardiac ischemia investigations (2). In our prospective study we would like to investigate of our cardioprotective strategies during on-pump cardiac operations with ischemia modified albumin. Methods: Fifty patients who needed coronary artery bypass operations according to AHA/ACC guidelines were taken to this study. All of the patients were elective cases and the operations were performed with standard cardiopulmonary bypass technique. During the cardiac arrest cold blood cardioplegia solution was used every 20 minutes (10 ml per kilogram) with antegrade technique through an aortic root cannula. Blood samples were taken before and at the end of operations. Cardiac troponin I, albumin, and ischemia modified albumin were investigated in these samples. Results: There were no deaths after the cardiac operations. The preoperative and postoperative echocardiographic evaluation of ejection fraction were in normal ranges and there were no significant changes. The ischemia modified albumin levels were significantly increased after the cardiac operations (p < 0.05), while cardiac troponin I levels did not show any statistically significant difference. The albumin levels were significantly decreased after the operations. Conclusions: Ischemia modified albumin is a sensitive and reliable marker of ischemia during on-pump cardiac operations. This marker can be used with all other markers in order to evaluate the optimal cardioprotective strategy.