Abstract 13999: Prognostic Significance of Albuminuria on Cardiovascular Outcomes in Patients with Mild Renal Dysfunction who Underwent Elective PCI
Background: The aim of this study was to investigate the association between elevated urinary albumin excretion rate and clinical cardiovascular outcomes in patients with mild renal dysfunction who underwent elective PCI.
Methods: A total of 120 consecutive patients with early stage CKD ( estimated GFR ≧ 60ml/min/1.73m2 ) who underwent elective PCI were enrolled. Urinary albumin to creatinin ratio ( ACR; mg/gCr) was measured and patients were divided into three groups as follows; patients without albuminuria (ACR < 30 mg/gCr, 81 patients ), those with microalbuminuria (30 ≦ ACR ≦300 mg/gCr, 30 patients ) and those with macroalbuminuria ( 300 < ACR mg/gCR, 9 patients ). The endpoint of this study was MACE defined as the composite of cardiovascular death, myocardial infarction and any revascularization.
Results: During the median follow-up of 1048 days, total 42 events occurred. The 3-year rates for MACE were 25.9% in the patients without albuminuria, 50.0% in those with microalbuminuria, and 66.7% in those with macroalbuminuria by Kaplan-Meier survival rate (Log rank p=0.007, figure). In cox analysis, albuminuria is approved to be an independent predictor of MACE even after adjustment for age, sex, and conventional risk factors ( hazard ratio 2.43; 95% CI 1.239-4.778; p=0.010). When patients were compared to those without albuminuria group, adjusted hazard ratio for the macroalbuminuria group was 3.96 (95% CI 1.369-11.433, p = 0.011 ) and 2.27 ( 95% CI 1.079-4.782, p = 0.031 ) for the microalbuminuria group.
Conclusions: The elevated urinary albumin excretion rate is an independent predictor of adverse cardiovascular outcomes and graded increase in the incidence of cardiovascular events across microalbuminuria to macroalbuminuria were observed in patients with mild renal dysfunction.
- © 2012 by American Heart Association, Inc.