Microalbuminuria in non-diabetic patients with unstable angina/non ST-segment elevation myocardial infarction.

Hilal B Al-Saffar ,Anna Mitchell,Sebastian Philipp,Hussein Nassir

doi:10.1186/s13104-015-1347-x

Abstract

BackgroundMicroalbuminuria (MAU) is defined as an urinary albumin excretion rate between 20–200 mg/l or 30–300 mg/day. It is a surrogate marker for endothelial dysfunction and is independently associated with atherosclerotis in diabetic and in non-diabetic patients. We assessed the prevalence of MAU in non-diabetic patients who presented with UA/NSTEMI and the relation of MAU to the severity of coronary artery disease in patients at a cardiac care center in Iraq.MethodsSeventy non-diabetic patients referred to the Iraqi Center for Heart Disease, Baghdad, between November 1st 2010 and June 1st 2011 with the diagnosis of UA/NSTEMI were included in this study. Physical examination, ECG and echocardiography were performed on all patients. TIMI (“Thrombolysis in Myocardial Infarction”) risk score was obtained. Urine samples were collected and sent for quantitative determination of MAU. All patients underwent diagnostic coronary angiography. Data are give as mean (quantitative and percent) ± SD.ResultsFifty-three men (76 %) and 17 (24 %) women (mean age 56 ± 12 years) were investigated. Overall 37 (53 %) individuals presented with arterial hypertension and 41 (59 %) with a history of smoking. 58 patients (83 %) had ischemic ECG changes (defined as ST segment depression more than 1 mm from baseline, and/or T wave inversion), 52 (74 %) had echocardiographic findings indicative of ischemia (defined as segmental wall motion abnormalities). Twenty-one (30 %) patients tested positive for MAU. There was a significant correlation of echocardiographic signs of ischemia and MAU, (n = 20 (38 %), p < 0.01). There was a clear relationship between MAU and TIMI risk score. Additionally, MAU was more common in patients with multivessel coronary artery disease (CAD) (p < 0.001). There was no statistically significant correlation between MAU and mean age, sex, smoking, and blood pressure.ConclusionIn this analysis of patients with UA/NSTEMI we found a strong correlation of microalbuminuria with echocardiographic changes and findings in coronary angiography.

Highlights

MAU is defined as an urinary albumin excretion rate between 20–200 mg/l or 30–300 mg/day
Cardiovascular disease leads to acute coronary syndrome as unstable angina (UA) and non-ST-segment elevation MI (NSTEMI)
A similar result was obtained by Klausen et al, who found that MAU is a strong determinant of coronary artery disease and death independently of age, sex, hypertension, diabetes mel‐ litus (DM), renal function, and lipid profile [28]

Summary

Introduction

Microalbuminuria (MAU) is defined as an urinary albumin excretion rate between 20–200 mg/l or 30–300 mg/day. It is a surrogate marker for endothelial dysfunction and is independently associated with athero‐ sclerotis in diabetic and in non-diabetic patients. MAU is defined as an urinary albumin excretion rate between 20–200 mg/l or 30–300 mg/day. It can be defined as persistent excretion of albumin in the urine at rates that are above normal range but below values detected by. The normal range for urinary albumin excretion rate is less than 30 mg/day.

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Conclusion