Role of albumin creatinine ratio in predicting of coronary artery disease

Abstract

The present study was done to investigate the association between the level of micro albuminuria and the severity of coronary artery disease angiographically. The study is conducted on 70 patients who underwent coronary angiography in many cardiac centres (NHI, PAMCC) in National heart Institute and Arar cardiac centre Saudi Arabia. The population study was divided into 2 groups according to micro albuminuria. Group (I) include 46 patients with angiographic evidence of coronary heart disease and without micro albuminuria. Group (II) include 24 patients with angiographic evidence of coronary heart disease and having micro albuminuria. Patients are subjected to full medical history, through physical examination. 12 lead ECG, fasting blood sugar, Lipid profile, blood urea and serum creatinine levels are obtained. Urinary albumin was measured by Stanbio Total Protein LiquiColor based on the procedure developed by Watanabe et al. Creatinine was measured by creatinine jaffe`reaction.. The ratio of urine albumin to creatinine (ACR) was used to define microalbiminuria .The upper normal limit is 30 mg/g. Conventional Echo Doppler study using (Vivid 7, General Electric-Vingmed) was done to assess EF%. A diagnostic coronary angiogram was performed to assess the severity of CAD according to number of vessels affected and Gensini score estimation. Our study group comprised 70 patients; 56% were men and 44% women; 64% of them were hypertensive, 68% of them were dyslipidemics, 58 of them were smokers, 43% of them were with high BMI and 48% of them have a positive family history of CHD. The mean age was 58.850 ± 11.949 years (ranges from 33 to 81 years). As per Cath Results; 36% CA results were normal, 38% CA results had a one vessel disease and 26% CA results had multivessel disease. For Albumin Creatinine ration 60% had normal results and 40% had abnormal albumin creatinine ratio; of those with high ALB/CR ratio 42% of them had a one vessel disease and 58% of them had multivessel disease. It is also found that micro albuminuria is productive for CAD independently with other risk factors It seems that micro albuminuria increase severity and number of CAD lesions and aggressive treatment of micro albuminuria may beneficial in CAD patients