Abstract: Objective The aim of this study was to evaluate the efficiency of ischemia-modified albumin (IMA) for predicting major adverse cardiovascular events (MACE) in chronic kidney disease (CKD) patients. Methods A total of 222 CKD patients were enrolled in this study. Baseline characteristics, IMA level and other laboratory measurements were collected and analyzed. The primary end point was the occurrence of MACE. Results A total of 213 participants finally completed this study, and 9 CKD patients were excluded because of dialysis treatment. They were divided into normal IMA group (IMA <85 KU/L, n=159, average IMA=77.12±10.43 KU/L) and high IMA group (IMA >85 KU/L, n=54, average IMA=90.33±12.20 KU/L). At the end of follow-up, the prevalence of MACE was 20.75% (33 cases) in normal IMA group and was 35.19% (19 cases) in high IMA group (χ2=4.549, P=0.033). Logistic regression analysis showed that IMA (OR=1.104, 95% CI 1.033 ~1.178; P=0.028) and hs-CRP (OR=1.232, 95% CI 1.109~1.342; P=0.001) were the independent risk factors for MACE in CKD patients. Kaplan-Meier survival analysis showed that the CKD patients with higher IMA level had lower non-MACE survival rate (Log-rank test, χ2=15.830, P＜0.001), indicating that the CKD patients with higher IMA level have higher prevalence of MACE. Conclusions CKD patients with higher IMA level had higher prevalence of MACE. IMA was the independent risk factors for MACE. Therefore, IMA may be a predictive marker for MACE in CKD patients.

Key words: Ischemia modified albumin, chronic kidney disease, major adverse cardiovascular events, predictive value