PP.01.24

Abstract

Objective: In recent studies, microalbuminuria has been believed to relate to progressive coronary atherosclerosis and cardiac event in diabetes. However, it has been unknown the relation between microalbumiuria and cardiac event in non-diabetes. The aim of this study accesses to relation between microalbumiuria and cardiac event in non-diabetes.Design and method: The study was a retrospective analysis of the findings in the 828 consecutive patients at our outpatient clinic between 2009 and 2012. The patients was excluded diabetes and overt albuminuria defined as UACR > 300 mg/g. Patients were divided into 2 groups according to UACR; normoalbuminuria (n = 706, 76.1%) and microalbuminuria (n = 222, 23.9%). Normoalbuminuria was defined as urine albumin-creatinine ratio (UACR) < 30 mg/g and microalbuminuriais was defined as 30 mg/g < = urine albumin-creatinine ratio (UACR) < 300 mg/g. All patients were followed for 33 ± 14 months. The endpoints were all cardiac events, defined as cardiac death, nonfatal myocardial infarction, and revascularization. Results: The patients were 446 men and 482 women (76:24%) with mean age of 57.3 ± 10.1 years (normoalbuminuria: 57.5 ± 10.1 years, microalbuminuria: 57.3 ± 10.2 years) and mean UACR is 18.6 ± 26.3 mg/g (normoalbuminuria: 8.5 ± 4.7 mg/g, microalbuminuria: 50.7 ± 38.3 mg/g). There were no difference of clinical characteristics and medication history including aspirin, angiotensin converting enzyme inhibitor (ACE inhibitor) and statin between normoalbuninuria and microalbuminuria. All cardiac events were revascularization without cardiac death and nonfatal myocardial infarction. (n = 28, 3.0%) In univariate analysis, microalbuminuria was predictor of cardiac events (normoalbuminuria vs microalbuminuria: 2.3% vs 5.4%, HR: 2.5, 95% CI: 1.1–5.3, p = 0.024). In multivariate analysis after adjustment of age, sex, body mass index, hypertension, medication and ejection fraction, microalbuminuria was the independent predictor of cardiac events (HR: 2.6, 95% CI: 1.1–6.2, p = 0.003). Stratifying our population by normoalbuminuria and microalbuminuria, Kaplan-Meier curves showed that normoalbuminuria had a better prognostic result compared with microalbuminuria. Conclusions: Microalbuminuria estimated UACR might be significantly independent predictor of cardiac event in non-diabetes.