Effects of peripheral vascular intervention on ischemia-modified albumin

被引:18
作者
Hacker, Marcus
Hoyer, Hans X.
la Fougere, Christian
Akcakoyunlu, Esin
Schuhmann, Christoph
Foerster, Stefan
Weber, Christof
Reincke, Martin
Tiling, Reinhold
Sohn, Hae-Young
机构
[1] Univ Munich, Dept Nucl Med, D-80336 Munich, Germany
[2] Univ Munich, Dept Clin Radiol, Munich, Germany
[3] Univ Munich, Med Klin Innenstadt, Dept Cardiol, D-8000 Munich, Germany
[4] Univ Munich, Med Klin Innenstadt, Dept Internal Med, D-8000 Munich, Germany
关键词
atherosclerosis; cardiac stress test; coronary artery disease; peripheral vascular disease; vulnerable plaque;
D O I
10.1097/MCA.0b013e3281ac2094
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 123.5 178 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 3h 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.
引用
收藏
页码:375 / 379
页数:5
相关论文
共 21 条
[1]  
Anwaruddin S, 2005, AM J CLIN PATHOL, V123, P140
[2]   A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia - A preliminary report [J].
Bar-Or, D ;
Lau, E ;
Winkler, JV .
JOURNAL OF EMERGENCY MEDICINE, 2000, 19 (04) :311-315
[3]   Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: A preliminary comparison to creatine kinase-MB, myoglobin, and troponin I [J].
Bar-Or, D ;
Winkler, JV ;
VanBenthuysen, K ;
Harris, L ;
Lau, E ;
Hetzel, FW .
AMERICAN HEART JOURNAL, 2001, 141 (06) :985-991
[4]   Evaluation of human serum albumin cobalt binding assay for the assessment of myocardial ischemia and myocardial infarction [J].
Bhagavan, NV ;
Lai, EM ;
Rios, PA ;
Yang, JS ;
Ortega-Lopez, AM ;
Shinoda, H ;
Honda, SAA ;
Rios, CN ;
Sugiyama, CE ;
Ha, CE .
CLINICAL CHEMISTRY, 2003, 49 (04) :581-585
[5]   High ischemia-modified albumin concentration reflects oxidative stress but not myocardial involvement in systemic sclerosis [J].
Borderie, D ;
Allanore, Y ;
Meune, C ;
Devaux, JY ;
Ekindjian, OG ;
Kahan, A .
CLINICAL CHEMISTRY, 2004, 50 (11) :2190-2193
[6]  
Christenson RH, 2001, CLIN CHEM, V47, P464
[7]   MORTALITY OVER A PERIOD OF 10 YEARS IN PATIENTS WITH PERIPHERAL ARTERIAL-DISEASE [J].
CRIQUI, MH ;
LANGER, RD ;
FRONEK, A ;
FEIGELSON, HS ;
KLAUBER, MR ;
MCCANN, TJ ;
BROWNER, D .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (06) :381-386
[8]   Prognostic significance of ischemia modified albumin after percutaneous coronary intervention [J].
Dusek, J ;
St'ásek, J ;
Tichy, M ;
Bis, J ;
Gregor, J ;
Vojácek, J ;
Masín, V ;
Polansky, P ;
Brtko, M ;
Cernohorsky, D .
CLINICA CHIMICA ACTA, 2006, 367 (1-2) :77-80
[9]   Comparison of ischemia-modified albumin levels in patients undergoing percutaneous coronary intervention for unstable angina pectoris with versus without coronary collaterals [J].
Garrido, IP ;
Roy, D ;
Calviño, R ;
Vazquez-Rodriguez, JM ;
Aldama, G ;
Cosin-Sales, J ;
Quiles, J ;
Gaze, DC ;
Kaski, JC .
AMERICAN JOURNAL OF CARDIOLOGY, 2004, 93 (01) :88-90
[10]   Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina [J].
Hacker, Marcus ;
Jakobs, Tobias ;
Hack, Nicolas ;
Nikolaou, Konstantin ;
Becker, Christoph ;
von Ziegler, Franz ;
Knez, Andreas ;
Koenig, Andreas ;
Klauss, Volker ;
Reiser, Maximilian ;
Hahn, Klaus ;
Tiling, Reinhold .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2007, 34 (01) :4-10