Is albuminuria a myocardial infarction risk equivalent for atherothrombotic events?. Issue 1 (May 2015)

• Record Type: Journal Article
• Authors: Rein, Philipp; Saely, Christoph H.; Vonbank, Alexander; Fraunberger, Peter; Drexel, Heinz
• Is Part Of: Atherosclerosis. Volume 240:Issue 1(2015)
• Page Start: 21
• Page End: 25
• Publication Date: 2015-05
• Subjects: Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2015.02.037
• Languages: English
• ISSNs: 0021-9150

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Objective</title> <p id="abspara0010">People with chronic kidney disease frequently experience cardiovascular events. This study sought to investigate whether the presence of albuminuria displays a vascular risk equivalent to that in patients with prior myocardial infarction.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Albuminuria was defined as a urinary albumin to creatinine ratio of 30 μg/mg or greater in 852 consecutive patients undergoing coronary angiography. Prospectively, we recorded vascular events over 3.2 ± 1.2 years.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">From our patients, 513 (60.2%) had neither albuminuria nor a history of MI, 126 (14.8%) had albuminuria without prior MI, 137 (16.1%) did not have albuminuria but had a history of MI, and 76 (8.9%) had both, albuminuria and prior MI. Compared with the incidence of the composite endpoint among normoalbuminuric patients with no prior MI (11.9%), event rates nearly doubled both in patients with albuminuria without prior MI (24.6%; p = 0.003) and in normoalbuminuric patients with a history of prior MI (21.2%; p = 0.004) and were highest in patients with both, albuminuria and prior MI (36.8%; p < 0.001). Importantly, event rates were not significantly different between patients with albuminuria and no prior history of MI and those with normoalbuminuria but prior MI (p = 0.972). Moreover, the event rate in patients with both, albuminuria and history of MI, was significantly higher (p < 0.05) than in the two groups exhibiting only one of the two conditions.</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">This is the first study demonstrating that albuminuria is a CAD risk equivalent. Thus, cardiovascular risk factors in albuminuric patients should be treated as aggressively as in patients with prior MI.</p> </sec> </abstract>