Abstract 3486: Albuminuria is Associated with Angiographically Determined Coronary Atherosclerosis
Introduction: In spite of the overwhelming evidence linking albuminuria to cardiovascular events, data on its relationship to atherosclerosis are scarce and conflicting. It is still unclear whether albuminuria is associated with a particular phase of the atherothrombotic process.
Hypothesis: We assessed the hypothesis that albuminuria is associated with angiographically determined coronary atherosclerosis.
Methods: The urinary albumin-to-creatinine ratio (ACR) was determined and the eGFR was calculated by the quadratic Mayo Clinic equation in a large population of 907 consecutive patients undergoing coronary angiography for the evaluation of CAD.
Results: From our patients, 297 had an eGFR <90ml/min/1.73m2, and 212 had albuminuria (ACR ≥30 mg/g). When compared to subjects with both normal eGFR and normal urinary albumin excretion (n = 494), the prevalence of significant coronary stenoses (i.e. stenoses with lumen narrowing ≥50%) was significantly higher in patients with normal eGFR and albuminuria (n = 116) and in those with decreased eGFR and albuminuria (n = 96), but similar in those (n = 201) who had decreased eGFR but not albuminuria (52.8 vs. 65.5%, p = 0.013; 52.8 vs. 65.6%, p = 0.021; and 52.8 vs. 47.3%.; p = 0.183, respectively). Concordantly, in logistic regression analysis the ACR but not the eGFR predicted significant coronary stenoses after multivariate adjustment, with standardized adjusted odds ratios (OR) of 1.27 [95% CI 1.03 – 1.58]; p = 0.027 and 1.05 [0.89 – 1.28]; p = 0.61, respectively. The association between the ACR and significant coronary stenoses remained significant after further adjustment for eGFR (OR = 1.30 [1.04 – 1.62]; p = 0.021).
Conclusions: In conclusion, albuminuria is strongly associated with angiographically determined coronary atherosclerosis, independent of conventional cardiovascular risk factors and of the eGFR.