title: Effects of peripheral vascular intervention on ischemia-modified albumin.
abstract: Ischemia -modified albumin was regarded as an early marker of cardiac ischemia. On the other hand, it has been reported that increased ischemia-modified albumin levels are associated with unstable plaque processes like percutaneous coronary intervention, acute coronary syndrome or myocardial infarction. This prospective study aimed to investigate the role of ischemia-modified albumin in patients with peripheral vascular disease undergoing peripheral vascular intervention, a plaque-altering procedure without evidence of tissue ischemia. Peripheral vascular intervention was performed in 21 consecutive patients (68.2+/-13.3 years) with typical leg claudication and documented peripheral vascular disease. Additionally, 96 consecutive patients (66+/-12.0 years) undergoing routine exercise stress test for the exclusion of functionally relevant coronary artery disease were defined as controls. It was assumed that in the latter patients no unstable plaque-altering processes were present. Blood samples were drawn before, and 30 min and 3 h after, revascularization in the peripheral vascular intervention group, as well as before, and 30 min and 3 h after, maximum stress testing in the control group, respectively. Ischemia-modified albumin levels were analyzed using the albumin cobalt-binding test. In patients undergoing peripheral vascular intervention, ischemia-modified albumin increased from 116.6+/-19.1 U/ml at baseline to 132.0+/-19.3 U/ml 30 min after intervention (+14.4+/-15.7%, P<0.001) and decreased to 123.5+/-17.8 U/ml 3 h later (-5.7+/-10.5%, P<0.001 compared with postintervention, P<0.001 compared with baseline). The control group showed a slight but significant decrease in ischemia-modified albumin from 103.0+/-11.0 to 100.2+/-11.6 U/ml poststress (-2.2+/-11.5%, P<0.05) and returned close to baseline 3 h later (101.8+/-10.3 U/ml, +2.4+/-10.9%, P=NS, compared with poststress and with baseline). For both groups, ischemia-modified albumin showed no correlation with albumin (at baseline P=0.62) and total protein (P=0.67), but significant correlation with creatinine (P=0.04) and C-reactive protein (P=0.02). In addition, ischemia-modified albumin was independent of age, sex, alanine aminotransferase, aspartate aminotransferase, creatine kinase, creatine kinase-MB, cholesterol, and triglycerides. This study showed an increased basal ischemia-modified albumin level in patients with peripheral vascular disease undergoing peripheral vascular intervention. Ischemia-modified albumin levels transiently increased shortly after peripheral vascular intervention, indicating a strong correlation between serum concentration of ischemia-modified albumin and processes associated with acute plaque disruption/rupture.
authors.affiliation: Department of Nuclear Medicine, University of Munich, Munich, Germany. marcus.hacker@med.uni-muenchen.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Hacker
authors.forename: Hans X
authors.initials: HX
authors.lastname: Hoyer
authors.forename: Christian
authors.initials: C
authors.lastname: la Fougère
authors.forename: Esin
authors.initials: E
authors.lastname: Akcakoyunlu
authors.forename: Christoph
authors.initials: C
authors.lastname: Schuhmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Förster
authors.forename: Christof
authors.initials: C
authors.lastname: Weber
authors.forename: Martin
authors.initials: M
authors.lastname: Reincke
authors.forename: Reinhold
authors.initials: R
authors.lastname: Tiling
authors.forename: Hae-Young
authors.initials: HY
authors.lastname: Sohn
mesh_terms: D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D012709:Serum Albumin