Relation of Albuminuria to Angiographically Determined Coronary Arterial Narrowing in Patients With and Without Type 2 Diabetes Mellitus and Stable or Suspected Coronary Artery Disease
| Autor: | J. Breuss, Vlado Jankovic, Christoph H. Saely, Peter Fraunberger, Stefan Beer, Christian Boehnel, Lorenz Risch, Alexander Vonbank, Heinz Drexel, Philipp Rein |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty endocrine system diseases Coronary Artery Disease Coronary Angiography urologic and male genital diseases Coronary artery disease chemistry.chemical_compound Risk Factors Internal medicine Diabetes mellitus Prevalence Albuminuria Humans Medicine In patient Aged Retrospective Studies Creatinine business.industry Albumin Type 2 Diabetes Mellitus Middle Aged medicine.disease female genital diseases and pregnancy complications Diabetes Mellitus Type 2 chemistry Austria Cardiology Female Microalbuminuria medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | The American Journal of Cardiology. 107:1144-1148 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2010.12.011 |
| Popis: | Albuminuria is associated with atherothrombotic events and all-cause mortality in patients with and without diabetes. However, it is not known whether albuminuria is associated with atherosclerosis per se in the same manner. The present study included 914 consecutive white patients who had been referred for coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD). Albuminuria was defined as a urinary albumin/creatinine ratio ≥ 30 μg/mg. Microalbuminuria was defined as 30 to 300 μg albumin/mg creatinine, and macroalbuminuria as a urinary albumin/creatinine ratio of ≥ 300 μg/mg. The prevalence of stenoses of ≥ 50% was significantly greater in patients with albuminuria than in those with normoalbuminuria (66% vs 51%; p0.001). Logistic regression analysis, adjusted for age, gender, diabetes, smoking, hypertension, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, C-reactive protein, body mass index, estimated glomerular filtration rate, and the use of angiotensin-converting enzyme inhibitors/angiotensin II antagonists, aspirin, and statins, confirmed that albuminuria was significantly associated with stenoses ≥ 50% (standardized adjusted odds ratio [OR] 1.68, 95% confidence interval [CI] 1.15 to 2.44; p = 0.007). The adjusted OR was 1.54 (95% CI 1.03 to 2.30; p = 0.034) for microalbuminuria and 2.55 (95% CI 1.14 to 5.72; p = 0.023) for macroalbuminuria. This association was significant in the subgroup of patients with type 2 diabetes (OR 1.66, 95% CI 1.01 to 2.74; p = 0.045) and in those without diabetes (OR 1.42, 95% CI 1.05 to 1.92; p = 0.023). An interaction term urinary albumin/creatinine ratio*diabetes was not significant (p = 0.579). In conclusion, micro- and macroalbuminuria were strongly associated with angiographically determined coronary atherosclerosis in both patients with and those without type 2 diabetes mellitus, independent of conventional cardiovascular risk factors and the estimated glomerular filtration rate. |
| Databáze: | OpenAIRE |
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