Microalbuminuria acts as a potential risk marker of events microalbuminuria in patients (P) hospitalized with acute coronary syndrome (ACS) according to
S Ribeiro et al. Previous studies have shown that microalbuminuria is an indicator of generalized endothelial dysfunction and, as such, an indicator of cardiovascular risk. Often it is also associated with other atherosclerotic risk factors. The prognostic impact of microalbuminuria in patients (P) hospitalized with acute coronary syndrome (ACS) was evaluated in the present study.
Study recruited 464 P admitted with ACS. Urine sample from each patient was collected on the first day of hospitalization and 24-hour albuminuria was determined by the ratio of protein and creatinine. Based on the presence or absence of microalbuminuria, the population was divided into two groups. The group with microalbuminuria included older patients (70.89 years old ± 12.87 vs. 62.88 years old ± 12.96, p <0.001), more women (40.9 vs. 20%, p = 0.002), diabetics (38.6 vs. 23.8, p = 0.034), more P with prior stroke (18.2 vs. 5.3%, p = 0.006), lower glomerular filtration rate (62.14 ml/min/1, 73m2 ± 32.76 vs. 93.82 ml/min/1, 73m2 ± 39.50, p <0.001), prior chronic renal failure (15 vs. 2.55, p < 0.001) and fewer smokers (11.4 vs. 32.9%, p = 0.003).
Findings from the study showed that P with microalbuminuria had more left main disease (15.4 vs. 6.6%, p = 0.049), more major bleeding (6.8 vs. 1.2%, p = 0.008), more moderate to severe depression of left ventricle systolic function (26.2 vs. 9.5%, p = 0.001). Additionally, this group included more P with higher values of pro-BNP (70.5 vs. 26.5, p <0.001), C-reactive protein (79.5% vs. 56.5%, p = 0.003) and RDW (79.5 vs. 60.3%, p = 0.013).
Patients with microalbuminuria also had more KK class greater than or equal to II (56.8 vs. 30.3%, p <0.001), deterioration of in-hospital KK class (27.3 vs. 13.8%, p = 0.02) and first diagnosed atrial fibrillation (AF) (22.7 vs. 9.7%, p = 0.01). More days of hospitalization (8.4 ± 5.2 vs. 6.5 ± 3.5, p = 0.02) and more in-hospital death (9.1 vs. 1.8%, p = 0.004) was also reported in these patients.
Six-months data showed that patients with microalbuminuria have more symptoms of heart failure (60.9 vs. 25.2%, p <0.001) and higher mortality (13.6 vs. 3.2%, p = 0.002).
Multivariate analysis showed that the presence of microalbuminuria did not independently predict in-hospital and six-month death.
Summarizing the study data, S Ribeiro et al showed that the presence of microalbuminuria in P admitted with ACS was associated with more heart failure, more severe coronary disease, first diagnosed FA and more in-hospital and six-month death, representing a potential risk marker of events in this population. |
