Prognostic value of albuminuria on 1-month mortality in acute myocardial infarction
| Autor: | François Schiele, Nicolas Meneveau, Romain Chopard, Vincent Descotes-Genon, Joanna Oettinger, Marie France Seronde, Florent Briand, Yvette Bernard, Fiona Ecarnot, Jean-Pierre Bassand |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Population Myocardial Infarction urologic and male genital diseases Risk Assessment chemistry.chemical_compound Predictive Value of Tests Internal medicine medicine Albuminuria Humans Registries Myocardial infarction education education.field_of_study Creatinine biology business.industry Mortality rate C-reactive protein Prognosis medicine.disease Troponin Blood pressure chemistry biology.protein Cardiology Female France medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Heart Journal. 157:327-333 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2008.09.018 |
| Popis: | An increase in albuminuria occurs in the early days after acute myocardial infarction. The aim of this study was to assess the relation between albuminuria and 30-day mortality, as well as its incremental predictive value, on top of established prognostic parameters.Demographic, clinical, and biological characteristics at admission, as well as in-hospital treatments and 1-month survival, were recorded in 1,211 consecutive patients admitted for acute myocardial infarction. Albuminuria was assessed from an 8-hour overnight urine collection within the first 2 days using immunonephelemetry. The population was categorized into 3 groups according to albuminuria levels (20, 20-200, and200 microg/min). Among survivors on day 2, 52% (625/1,211) of patients had an albuminuria level20 microg/min, 39% (477) between 20 and 200 microg/min, and 9% (109)200 microg/min. High levels of albuminuria were associated with older age, peripheral vessel disease, systolic blood pressure, glucose, creatinine, troponin, B-type natriuretic peptide, and high-sensitivity C reactive protein levels, as well as use of angiography, angiotensin-converting enzyme inhibitors, and beta blockers. At 1 month, there was a significantly higher mortality rate in groups with higher albuminuria. After adjustment for baseline characteristics, patients with albuminuria level of20 microg/min had a 2.7-fold higher 30-day mortality, and those with200 microg/min had an almost 4-fold higher 30-day mortality compared to those with albuminuria level of20 microg/min. The addition of albuminuria information improved the discrimination capacity of the model and the global risk prediction.Albuminuria level, taken as a quantitative or categorical variable, is an independent and powerful predictor of mortality after acute myocardial infarction. |
| Databáze: | OpenAIRE |
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