Albuminuria Predicts Cardiovascular Events After PCI
Patients with elevated albumin excretion rate have increased risk of adverse cardiovascular outcomes.
(HealthDay News) -- An elevated urinary albumin excretion rate can predict adverse cardiovascular outcomes in patients undergoing elective percutaneous coronary intervention, according to a study published in The American Journal of Cardiology.
Ayako Kunimura, MD, from the Nagoya University Graduate School of Medicine in Japan, and colleagues examined whether the urinary albumin excretion rate could predict cardiovascular events in a population of 698 patients requiring coronary revascularization. Patients who underwent elective percutaneous coronary intervention were classified according to baseline urinary albumin-to-creatinine ratio (ACR) as having normoalbuminuria (ACR <30 mg/gCr; 389 patients), microalbuminuria (ACR, 30 to 300 mg/gCr; 230 patients), or macroalbuminuria (ACR >300 mg/gCr; 79 patients).
The researchers found that 41 cardiovascular events occurred during a median follow-up of 1,564 days. The event-free survival rates were 89, 92, and 97%, respectively, for those with macroalbuminuria, microalbuminuria, and normoalbuminuria (P = 0.002). The hazard ratios for cardiac death and/or nonfatal myocardial infarction were 2.56 and 4.02 for those with microalbuminuria and macroalbuminuria, respectively, compared with normoalbuminuria (P = 0.01 and 0.003, respectively), after adjustment for conventional risk factors.
"In conclusion, an elevated urinary albumin excretion rate independently predicted adverse cardiovascular outcomes, with a gradual risk increase that progressed from microalbuminuria to macroalbuminuria in patients undergoing elective percutaneous coronary intervention," the authors write.