Ischemia-modified albumin, a predictive marker of major adverse cardiovascular events in continuous ambulatory peritoneal dialysis patients

Abstract

Objectives: The aim of this study was to evaluate the efficiency of ischemia-modified albumin (IMA) for predicting major adverse cardiovascular events (MACE) in continuous ambulatory peritoneal dialysis (CAPD) patients.

Design and methods: A prospective observational study was conducted with 120 CAPD patients and 37 healthy volunteers. Demographic and clinical data were collected. The primary end point is the occurrence of MACE.

Results: A total of 157 participants with a mean age of 43.64 years finally completed this study. The CAPD patients had a significantly high rate of MACE (P=0.001) and high levels of IMA than healthy controls (P<0.001). Compared with CAPD patients with normal levels of IMA, the CAPD patients with high levels of IMA (>85 kU/L) had lower non-MACE survival rate (P<0.001), which indicated that the high IMA CAPD patients may suffer a high rate of MACE. In addition, the high IMA CAPD patients also had a low level of serum albumin (P<0.001) and hemoglobin (P=0.018). The correlation analysis showed that the serum albumin level was the most effective factor influencing IMA (B=-0.967, P<0.001).

Conclusions: CAPD patients with high levels of IMA had a high incidence rate of MACE. IMA was a good predictive marker of MACE and might be important in cardiovascular risk stratification of CAPD patients.

Keywords: ACS; CAPD; Continuous ambulatory peritoneal dialysis; DBP; ESRD; IMA; Ischemia-modified albumin; LDL-c; MACE; Major adverse cardiovascular events; Predictive value; SBP; TC; WBC; acute coronary syndromes; continuous ambulatory peritoneal dialysis; diastolic blood pressure; end-stage renal disease; high sensitivity CRP; hs-CRP; ischemia-modified albumin; low density lipoprotein cholesterol; major adverse cardiovascular events; no occurrence of MACE; non-MACE; systolic blood pressure; total cholesterol; white blood cell.