Abstract 5824: Does Albumin Creatinine Ratio Add Prognostic Information After a Stroke? Data From NHANES III
Background: Microalbuminuria, as a proxy for systemic microvascular function, predicts future stroke and prognosis post myocardial infarction. We explored whether microalbuminuria predicts prognosis after stroke.
Methods: Urinary albumin creatinine ratio (ACR) measured during NHANES III was examined in those who reported a physician-diagnosed stroke aged 40 or over. Comparisons were made with those without stroke. Mortality and time to death were recorded.
Results: 404 and 8966 participants with a stroke and no stroke had ACR measured. Those with a stroke were older (P<0.001), heavier (p=0.03), had higher blood pressure (p<0.001) but smoking prevalence was similar. ACR was higher in those with a stroke than the general population (Age-adjusted ACR 14.3 (95% CI, 12.3–16.6) vs. 8.8 (8.3–9.1)μg/ml; p<0.001). ACR was stratified at a level of 7.8μg/ml (median value) and 20μg/ml (conventional cut off for microalbuminuria). Cox proportional hazards models demonstrated age, smoking status, blood pressure and ACR were significant predictors of mortality (table 1⇓). Conclusion: ACR as a proxy of systemic microvascular function predicts mortality independently of conventional cardiovascular risk factors including blood pressure. Further work should be performed to investigate whether early pharmacological intervention improving systemic microvascular function, as reflected in a reduced ACR, could improve outcomes after stroke.