Prognostic relevance of ischemia-modified albumin and NT-proBNP in patients with peripheral arterial occlusive disease

Background: Cardiovascular morbidity is high among patients with peripheral arterial occlusive disease (PAOD). The aim of this study was to evaluate the ability of ischemia-modified albumin (IMA), N-terminal proBNP (NT-proBNP), and high-sensitive cardiac Troponin T (hs-cTnT) to predict cardiovascular complications in male patients with Fontaine stage II PAOD. Methods: 68 men with stage II PAOD underwent treadmill testing. NT-proBNP, IMA and hs-cTnT were measured before and after exercise. Patients were followed up prospectively and complete follow-up data were available for 66 individuals. Results: Median follow-up time was 43.0 months. 12 (18.2%) patients had suffered from a major adverse cardiac event (MACE). IMA and NT-proBNP baseline concentrations were significantly higher in patients who developed MACE during follow-up: IMA: 110.6 +/- 2.4 kU/L vs. 102.5 +/- 0.9 kU/L (p < 0.001); NT-proBNP: 270.5 +/- 295.9 ng/L vs. 84.6 +/- 15.4 ng/L (p = 0.007). In multivariable regression models only IMA was significantly associated with the primary endpoint (HR = 1.07, CI 1.01-1.13; p = 0.029). Conclusion: In the present study, a serum concentration of >103.9 kU/L of IMA was a better independent predictor of MACE than NT-proBNP or hs-cTnT. IMA might be a valuable tool for risk stratification in PAOD patients. (C) 2014 Elsevier B.V. All rights reserved.