<?xml version="1.0" encoding="UTF-8"?><?xml-stylesheet type="text/xsl" href="static/style.xsl"?><OAI-PMH xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/ http://www.openarchives.org/OAI/2.0/OAI-PMH.xsd"><responseDate>2026-04-13T00:58:34Z</responseDate><request verb="GetRecord" identifier="oai:www.recercat.cat:10459.1/468689" metadataPrefix="mets">https://recercat.cat/oai/request</request><GetRecord><record><header><identifier>oai:recercat.cat:10459.1/468689</identifier><datestamp>2025-10-06T18:57:04Z</datestamp><setSpec>com_2072_3622</setSpec><setSpec>col_2072_479130</setSpec></header><metadata><mets xmlns="http://www.loc.gov/METS/" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:doc="http://www.lyncode.com/xoai" ID="&#xa;&#x9;&#x9;&#x9;&#x9;DSpace_ITEM_10459.1-468689" TYPE="DSpace ITEM" PROFILE="DSpace METS SIP Profile 1.0" xsi:schemaLocation="http://www.loc.gov/METS/ http://www.loc.gov/standards/mets/mets.xsd" OBJID="&#xa;&#x9;&#x9;&#x9;&#x9;hdl:10459.1/468689">
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                  <mods:namePart>Resano-Barrio, Pilar</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Gracia-Lavedan, Esther</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Solano-Pérez, Esther</mods:namePart>
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               <mods:name>
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                  <mods:namePart>García-Mediano, Belén</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Castillo-García, María</mods:namePart>
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               <mods:name>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Barbé Illa, Ferran</mods:namePart>
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               <mods:name>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>García-Rio, Francisco</mods:namePart>
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               <mods:name>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Sánchez-de-la-Torre, Manuel</mods:namePart>
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               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Mediano, Olga</mods:namePart>
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                  <mods:dateIssued encoding="iso8601">2025</mods:dateIssued>
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               <mods:abstract>Introduction
In the context of the prevailing interest in biomarkers that can assess cardiovascular (CV) risk in obstructive sleep apnea (OSA), ischemia-modified albumin (IMA) is proposed as a potential risk predictor.

Objectives
To evaluate whether IMA levels predict recurrent CV events in patients with acute coronary syndrome (ACS) and OSA, and whether continuous positive airway pressure (CPAP) treatment modifies this risk.

Methods
This post hoc analysis is based on data from the ISAACC study, including 1.011 non-sleepy patients with an ACS. During hospitalization for ACS, a sleep study was conducted and blood samples for IMA determination were obtained. Patients were categorized by their apnea–hypopnea index (AHI) in non-OSA (AHI &lt;15 events/h) or OSA group (AHI ≥15 events/h). “Low” or “high” IMA levels were established based on the median value (⩽ 34.1 U/L or > 34.1 U/L, respectively). The OSA group was randomized to either CPAP or usual care. The recurrence of CV events was evaluated over a 36-months follow-up.

Results
Adjusted cox regression models showed that the OSA group with high IMA level had a significantly reduced risk for CV event recurrence compared with the non-OSA group (HR [95 % CI] 0.59 [0.38–0.93], p = 0.024). In the OSA group with high IMA level, CPAP treatment did not significantly reduce CV recurrence.

Conclusions
OSA was associated with higher IMA levels in patients with ACS. Interestingly, patients with both OSA and high IMA experienced fewer CVEs during follow-up. CPAP treatment demonstrated a non-significant risk reduction in patients with low IMA, whereas no effect was noted in those with high IMA.</mods:abstract>
               <mods:language>
                  <mods:languageTerm authority="rfc3066"/>
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               <mods:accessCondition type="useAndReproduction">cc-by-nc-nd, (c) Pilar Resano-Barrio et al., 2025 Attribution-NonCommercial-NoDerivatives 4.0 International info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by-nc-nd/4.0/</mods:accessCondition>
               <mods:subject>
                  <mods:topic>Obstructive sleep apnea</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Cardiovascular risk</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Acute coronary syndrome</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Biomarkers</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Ischemia modified albumin</mods:topic>
               </mods:subject>
               <mods:titleInfo>
                  <mods:title>Ischemia-modified albumin and cardiovascular risk in obstructive sleep apnea and acute coronary syndrome. Long term follow-up after treatment from the ISAACC study</mods:title>
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