Albuminuria during acute coronary syndrome: A predictor for short term mortality and prognosis

Abstract

BackgroundAlbuminuria is associated with increased risk of morbidity and mortality in patients with acute coronary syndrome (ACS) than non-albuminuric patients. ObjectiveTo evaluate the presence of albuminuria and assess its prognostic significance for short term outcome during hospital stay in ACS. Materials & methodsPatients hospitalized with diagnosis of ACS were enrolled. ACS was defined as per ACC/ESC criteria. Albuminuria was measured as urinary albumin to creatinine ratio on first day of admission, and divided into three categories; normoalbuminuria (M0): <30 mg/gm, microalbuminuria (M1): 30–300 mg/gm, macroalbuminuria (M2): >300 mg/gm. Sample size of 124 was calculated with frequency of albuminuria of 30% in ACS (CI: 95%, alpha error – 0.05, power of study = 80% i.e. beta error = 0.2 and odds ratio between case and control group – 3). Patients were monitored and followed up closely during hospital stay. ResultsOne hundred and seventeen (117) patients out of 134 enrolled had albuminuria (87%; Males: 93, Females: 24). Patients presenting with blood sugar >140 mg/dl had significantly high albuminuria while those who consumed alcohol had significantly low. Complications were higher in patients with albuminuria than those with normoalbuminuria (p = 0.02). Complications increased as the level of albuminuria increased with highest in macroalbuminuric group (p = 0.005). In multivariate analysis, the variables which significantly affected the outcome were systolic blood pressure >140 mmHg, smoking, type 2 diabetes mellitus and age >65 years. Though albuminuria was not significant variable in multivariate analysis, it showed tendency to develop complications (OR – 3.28, 95% CI: 0.95–11.4). ConclusionAlbuminuria is highly prevalent in patients ACS. It is a useful variable for predicting short term outcome in patient with ACS.