Abstract
BackgroundData are limited with regard to the relationship of albuminuria and major adverse cardiovascular events (MACE) in Chinese elder patients with high cardiovascular risk.MethodsWe did a retrospective cohort study using Chinese elder patients with high cardiovascular risks (n = 1474) to identify the association of albumin-to-creatinine ratio (ACR) and the incidence of MACE and all-cause mortality. Individuals were followed up from January, 2002 to November, 2007. The all-cause mortality and MACE, composite outcome of cardiovascular death, myocardial infarction, stroke and hospitalization of congestive heart failure were defined as primary endpoint.ResultsDuring the median following up of 56 months, 213 patients developed primary endpoint and 117 patients died. Patients with higher baseline urinary ACR (> 30 mg/g) experienced a nearly 2-fold of all-cause mortality and a 3-fold of heart failure hospitalization than those with lower baseline urinary ACR (≤10 mg/g).MACE, cardiovascular death, stoke and myocardial infarction showed no difference in three grades of urinary ACR (> 30 mg/g, 10 mg/g-30 mg/g, ≤10 mg/g) in this cohort. Patients above 65 years with increased ACR tended to experience higher mortality risks, and the association of increased ACR with higher hospitalization of congestive heart failure seemed to be more prominent in patients below 65 years than above 65 years.ConclusionsIn this post hoc analysis of Chinese individuals with high cardiovascular risks, higher urinary ACR was associated with higher all-cause mortality and heart failure hospitalization. Further studies are needed to find out whether there is age-specific ACR cutoff point.
Highlights
Data are limited with regard to the relationship of albuminuria and major adverse cardiovascular events (MACE) in Chinese elder patients with high cardiovascular risk
Previous study [10] has confirmed that albumin to creatinine ratio (ACR) levels of 10 mg/g and 30 mg/g are associated with 1.2 and 1.6 fold relative risks of all-cause mortality compared with ACR level of 5 mg/g
It is of interest to know whether albuminuria below thresholds or above the “overt albuminuria” has indication for cardiovascular events and all-cause mortality
Summary
Data are limited with regard to the relationship of albuminuria and major adverse cardiovascular events (MACE) in Chinese elder patients with high cardiovascular risk. Cardiovascular disease (CVD) is a major and growing global social and public healthcare problem, accounting for nearly 50% all deaths in industrialized countries and about 25% in other countries [1]. Albuminuria could be a potential target for intervention to improve major cardiovascular outcome. The urine albumin to creatinine ratio (ACR) is commonly used as an index of albuminuria. Previous study [10] has confirmed that ACR levels of 10 mg/g and 30 mg/g are associated with 1.2 and 1.6 fold relative risks of all-cause mortality compared with ACR level of 5 mg/g. It is of interest to know whether albuminuria below thresholds or above the “overt albuminuria” has indication for cardiovascular events and all-cause mortality
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