Abstract 14630: Microalbuminuria, Coronary Atherosclerosis, and Long-Term Clinical Outcome in Asymptomatic Type 2 Diabetic Patients: Evaluation by Coronary CT Angiography
Background: Coronary CT angiography (CCTA) is a highly accurate tool for detection of coronary atherosclerosis in asymptomatic type 2 diabetic patients. Multiple lines of evidence demonstrate a strong association between the presence of microalbuminuria and the risk of adverse cardiovascular outcome in type 2 diabetes. However, the association of microalbuminuria with the presence, extent and severity of coronary artery disease (CAD) has not been reported in asymptomatic diabetic patients since the introduction of CCTA.
Methods: We consecutively enrolled 260 asymptomatic type 2 diabetic patients without known CAD who underwent 64-channel dual-source CCTA and performed measurement of albumin in their 24-hour urine collection and analyzed their coronary atherosclerosis. Microalbuminuria was defined as levels of urinary albumin excretion between 30 and 300 mg/day. We compared the prevalence, extent and severity of coronary atherosclerosis between groups. All-cause mortality was assessed by risk-adjusted Cox proportional hazards models during 5 years follow-up.
Results: Higher rates of obstructive CAD (by stenosis ≥50%, p=0.01; by stenosis ≥70%, p=0.001) and multivessel disease (p=0.005) were noted for patients with microalbuminuria. The number of any plaques more than 50% stenosis in entire coronary arteries was higher in patients with microalbuminuria (p=0.017). Morever, microalbuminuria was an independent predictor of all-cause mortality after adjusting conventional risk factors and glomerular filtration rate (hazard ratio 2.718, confidence interval 1.053-7.016, p=0.039).
Conclusions: The presence of microalbuminuria is associated with the increased prevalence, extent and severity of coronary atherosclerosis on CCTA and the risk of all-cause mortality in asymptomatic type 2 diabetic patients.
- © 2013 by American Heart Association, Inc.