High albumin-corrected anion gap linked to increased MACE risk in CKD patients after PCI

A retrospective cohort study examined the prognostic value of albumin-corrected anion gap (ACAG) in 973 chronic kidney disease patients (estimated glomerular filtration rate ≤ 60 mL/min/1.73 m²) undergoing percutaneous coronary intervention at Tianjin Medical University Second Hospital. Patients were categorized into high and low ACAG groups based on a receiver operating characteristic cutoff, with the low-ACAG group serving as the comparator.

The primary outcome was time-to-first major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, recurrent myocardial infarction, or non-fatal stroke. During a mean follow-up of 918.0 ± 364.7 days, the high-ACAG group experienced significantly higher MACE incidence (29.65%) compared to the low-ACAG group (15.78%), with P < 0.001. Secondary outcomes included all-cause mortality, individual MACE components, recurrent MACE, and any repeat revascularization, though specific results for these endpoints were not reported.

Safety and tolerability data were not reported. Key limitations include the single-center design and retrospective nature, which prevents causal inference. The study population was limited to Chinese patients with chronic kidney disease undergoing PCI, potentially limiting generalizability to other populations or settings. Funding sources and conflicts of interest were not reported.

For clinical practice, this study identifies an association between elevated albumin-corrected anion gap and worse cardiovascular outcomes in a specific patient population. However, given the observational design and single-center nature, these findings should be interpreted cautiously and require prospective validation before influencing clinical decision-making. The ACAG measurement may warrant further investigation as a potential prognostic marker in this population.

Researchers looked at a blood measure called the albumin-corrected anion gap (ACAG) in patients with chronic kidney disease. The study included 973 patients from one hospital in China who had a procedure to open blocked heart arteries. They were followed for about two and a half years on average. The goal was to see if this blood test result was linked to future heart problems.

The main finding was that patients with a higher ACAG level had more major heart events. These events included heart-related death, another heart attack, or a non-fatal stroke. About 30% of people in the high ACAG group had one of these events, compared to about 16% in the low ACAG group. The study did not report on specific safety concerns or side effects related to the test itself.

It is important to be careful with these results. This was a retrospective study, meaning researchers looked back at old medical records. This type of study can show a link, but it cannot prove that a high ACAG causes heart problems. Also, because it was done at just one hospital, the results might not apply to everyone. Readers should see this as an early finding that points to a potential new area for doctors to watch. More research is needed to confirm if this blood test is truly useful for predicting risk.