Abstract 15491: Albuminuria is Associated With Angiographically Determined Coronary Atherosclerosis Both in Patients With Type 2 Diabetes and in Non-Diabetic Individuals
Objectives: Albuminuria is associated with atherothrombotic events and all-cause mortality in patients with diabetes as well as in non-diabetic individuals. However, it is not known whether albuminuria is associated with directly visualised atherosclerosis in the same manner.
Methods: We enrolled 909 consecutive Caucasian patients, including 226 patients with type 2 diabetes (T2DM) and 683 non-diabetic subjects who were referred to coronary angiography for the evaluation of stable coronary artery disease (CAD). Elevated urinary albumin excretion (UAE) was defined as an urinary albumin to creatinine ratio (ACR) ≥30 μg/mg; significant CAD was diagnosed in the presence of coronary artery lumen narrowing ≥50%.
Results: The prevalence of significant CAD was significantly higher in patients with an elevated UAE than in those with normal UAE (65.9 vs. 51.4%; p<0.001). Logistic regression analysis adjusting for age, gender, smoking, hypertension, LDL cholesterol, HDL cholesterol, CRP, BMI, use of ace/angiotensin II antagonists, aspirin and statins, as well as for the gomerular filtration rate (eGFR) and for T2DM confirmed elevated UAE as a significant predictor of angiographically determined CAD (OR=1.68 [1.15–2.44]; p=0.007). Similarly, the ACR was significantly associated with significant CAD when treated as a continuous variable (standardized adjusted OR=1.45 [1.13–1.86]; p=0.004). The prevalence of elevated UAE was significantly higher in patients with T2DM than in non-diabetic patients (38.9 vs. 18.0%; p<0.001). Like in the total study cohort, the prevalence of significant CAD was higher in patients with elevated UAE than in those with normal UAE out both in patients with diabetes (75.0 vs. 60.9%; p=0.028) and in those without diabetes (59.3 vs. 49.1; p=0.040). Concordantly, the ACR proved significantly predictive of significant CAD both in patients with T2DM (1.66 [1.01–2.74]; p=0.045) and in patients without diabetes (1.42 [1.05–1.92]; p=0.023) in a fully adjusted model.
Conclusions: In conclusion, an elevated UAE is strongly associated with angiographically determined coronary atherosclerosis both in patients with T2DM and in non-diabetic patients, independent of conventional cardiovascular risk factors and of the eGFR.
- © 2010 by American Heart Association, Inc.