Relationship between Urinary Albumin Creatinine Ratio and Severity of Coronary Artery Disease in Non-Diabetic Patients (original) (raw)
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Association of Albumin to Creatinine Ratio with Severity of Coronary Artery Disease
University Heart Journal, 2015
Atherosclerotic coronary heart disease is the leading cause of death in developed world 1. South Asians have a higher prevalence of CAD as compared with other ethnicities, with a higher rate at younger age 2,3. The term microalbuminurea (MA) is defined as urinary albumin levels of more than or equal to 30-300mg/24 hours in 24 hours urine collection or albumin-creatinine ratio (ACR) of >30-300mg/gm creatinine in random spot urine sample. The measurement of albumin to creatinine ratio (ACR) in random spot urine has become a widely accepted clinical tool for assessing urinary albumin excretion 4. Microalbuminurea has been identified as an independent risk factor for determining both short and long term
Medical science monitor : international medical journal of experimental and clinical research, 2010
The aim of this study was to investigate whether the amount of urinary albumin concentration (UAC) or urinary albumin to creatinine ratio (UACR) is more strongly associated with angiographically documented coronary artery disease (CAD). A total of 199 consecutive patients [11 9(60%) male, 80 (40%) female, mean age =57±10] undergoing diagnostic coronary angiography were included in the study. Significant coronary artery disease was defined as a stenosis equal to or above 50% in the main coronary artery or in one of the other branches. UAC and UACR were calculated from the urine. Baseline clinical parameters, UAC and UACR were compared between subjects with and without CAD. Factors predicting CAD were evaluated by multivariate analysis. Baseline clinical and laboratory characteristics of patients with and without CAD were not different except for a slightly male predominance in patients with CAD. Patients with CAD had significantly higher UACs and UACRs than patients without CAD (32.1...
Can Urine Protein to Creatinin Ratio Predict the Severity of Coronary Artery Disease
Journal of Isfahan Medical School, 2009
BACKGROUND :Albuminuria is one of the abnormalities which occur in diabetics. Different studies have shown its relationship with cardiovascular diseases but few studies have been performed to show the relationship between albuminoria level and coronary artery disease (CAD) severity. This study was designed to asses the relationship between albuminuria and coronary artery disease severity. METHODS: In this cross-sectional study, the 164 Non-Insulin Dependent Diabetes Mellitus patients with angina pectoris who hospitalized for diagnostic or therapeutic angiography in Isfahan Chamran hospital were included. Urine Pr/Cr ratio has been calculated in all patients, using the first sample of morning urine. The standard angiography video has been assessed by three cardiologists through Seldinger method. CAD score has been given from 0 to 21 based on Extent method. The relationship between CAD severity and urine Pr/Cr ratio has been assessed with bivariate correlation methods and multivariate...
Albumin to creatinine ratio as a predictor to the severity of coronary artery disease
Alexandria Journal of Medicine, 2013
Introduction: Microalbuminuria (MA) is a well-known risk factor for coronary artery disease (CAD). It is associated with higher cardiovascular mortality, especially in diabetics. However, there are few data linking angiographic severity of CAD to MA. Aim: The aim of the present study was to assess the albumin to creatinine ratio as a new predictor for CAD and to correlate with its severity apart from other traditional CAD risk factors. Methods: Our study included 100 patients with documented CAD by coronary angiography in Alexandria main university hospital. The severity of CAD was scored on the basis of the number and the extent of lesions within the coronary arteries by using Syntax score. Urine albumin excretion was measured for all patients in morning spot urine samples by immune precipitation technique. We correlate between MA and severity of CAD. Results: In a total of 100 patients (74 males and 26 females), (mean age 55.71 ± 8.99 y) MA was present in 34 patients only. Patients were divided into two groups; group I included those without MA and group II with MA. CAD occurred more frequently in males than in females and in smokers than in non-smokers. There were no significant differences in the prevalence of hypertension and hypercholesterolemia between the two groups. A direct relationship between MA and extension of atherosclerotic coronary lesions was noticed (P = 0.009).
Family Medicine & Primary Care Review
Background. Diabetic nephropathy (DN) is one of the chronic microvascular complications of type 2 diabetes mellitus (T2DM). Microalbuminuria is a marker that can be used in detecting these complications so that preventive measures can be taken. Objectives. This study aimed to detect DN as T2DM complications by measurement of the urine albumin-to-creatinine ratio (ACR) as a marker and to analyze the factors that may influence the ratio in T2DM patients. Material and methods. The study design was a correlative study with a cross-sectional approach. The study population was all T2DM patients who regularly visit the diabetic clinic and primary health care in Medan. The sample size consisted of 89 subjects, while the subjects were recruited by consecutive sampling. Data was processed using SPSS and was analyzed using descriptive statistics and one-way ANOVA. Results. The study results showed that most T2DM patients had normal to mildly increased ACR levels in 49 subjects (55.1%). There was a relationship between increased ACR levels with blood glucose level (BGL) (p = 0.01), HbA 1c (p = 0.03), HDL-C (p = 0.01) and triglyceride (p = 0.04). In contrast, increased ACR levels had no relationship with age (p = 0.27), duration of illness (p = 0.13), systolic blood pressure (p = 0.31), total cholesterol (p = 0.90) and LDL-C (p = 0.89), respectively. Conclusions. The study showed that BGL, HbA 1c , HDL-C and triglyceride had a strong relationship with the increased ACR level, which is believed to be a DN marker. ACR can be a screening tool for DN in T2DM patients and other T2DM complications, such as cardiovascular complications and retinopathy.
Impact of the Albumin to Creatinine Ratio and the Coronary Artery State on Vascular Events
The American Journal of Cardiology, 2014
Albuminuria is an important indicator of cardiovascular risk. However, whether albuminuria predicts cardiovascular events independently of the baseline coronary artery state has not yet been investigated. We measured urinary albumin and creatinine concentrations in 867 consecutive patients who underwent coronary angiography for the evaluation of suspected or established stable coronary artery disease (CAD). Albuminuria was defined as a urinary albumin to creatinine ratio of 30 mg/mg or greater. Prospectively, we recorded the vascular events over 3.2 -1.2 years. From our patients, 318 had neither albuminuria nor significant CAD (i.e., coronary stenoses ‡50%) at baseline angiography, 69 had albuminuria but no significant CAD, 343 did not have albuminuria but significant CAD, and 137 had both albuminuria and significant CAD. Compared with the event rate among patients with neither albuminuria nor significant CAD (8.2%), event rates were significantly higher in patients with albuminuria without significant CAD (18.8%; p [ 0.002) and in normoalbuminuric patients with significant CAD (19.2%; p <0.001); it was highest in patients with both albuminuria and significant CAD (33.6%; p <0.001). Importantly, event rates were similar in patients with albuminuria free of significant CAD and those with significant CAD but normoalbuminuria (p [ 0.767). In conclusion, this is the first study demonstrating that albuminuria per se is a CAD risk equivalent after adjusting for the angiographically proven atherosclerotic state at baseline. Ó 2014 Elsevier Inc. All rights reserved. (Am J Cardiol 2014;113:1616e1620)
Influence of Albuminuria on Cardiovascular Risk in Patients With Stable Coronary Artery Disease
Circulation, 2007
Background— Patients with chronic kidney disease are at increased risk for cardiovascular morbidity and mortality. We assessed the association between albuminuria and the risks for death and cardiovascular events among patients with stable coronary disease. Methods and Results— We studied patients enrolled in the Prevention of Events with an ACE inhibitor (PEACE) trial, in which patients with chronic stable coronary disease and preserved systolic function were randomized to trandolapril or placebo and followed up for a median of 4.8 years. The urinary albumin to creatinine ratio (ACR) assessed in a core laboratory in 2977 patients at baseline and in 1339 patients at follow-up (mean 34 months) was related to estimated glomerular filtration rate and outcomes. The majority of patients (73%) had a baseline ACR within the normal range (<17 μg/mg for men and <25 μg/mg for women). Independent of the estimated glomerular filtration rate and other baseline covariates, a higher ACR, eve...
Serum Creatinine and Occurrence and Severity of Coronary Artery Disease
Medical Archives, 2019
Introduction: The risk for cardiovascular disease is increased in all stages of the impairment of renal function. It is proposed that serum creatinine is a marker of diabetes and coronary artery disease (CAD) as well as the kidney function. Aim: to study the association of serum creatinine with the likelihood and severity of CAD. The study population consisted of 262 males and 266 females who were classified as CAD cases and controls according to the results of coronary angiography. Results: Patients with CAD compared with the controls had increased levels of serum urea and creatinine. Serum creatinine showed significant positive correlation with male sex, hypertension and negative correlation with total-and HDL-cholesterol and apoAI. Serum urea, uric acid and potassium were the major determinants of creatinine. All hematological parameters were strong negative correlates of creatinine. None of markers of inflammation had significant correlation with creatinine. Creatinine was associated significantly with the prevalence [odds ratio of 1.79 (1.47-2.20), p<0.001] and severity of CAD [F(3,528)= 3.0, p=0.03]. Serum creatinine was excluded from the regression equation after adjustment for major risk factors. Conclusion: Serum creatinine has significant association with CAD, but the correlation is not independent. Creatinine have significant association with markers of kidney function and body water status, but not with markers of inflammation and insulin function.
BMC nephrology, 2016
This study compared the combination of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) vs. eGFR and urine protein reagent strip testing to determine chronic kidney disease (CKD) prevalence, and each method's ability to predict the risk for cardiovascular events in the general Japanese population. Baseline data including eGFR, UACR, and urine dipstick tests were obtained from the general population (n = 22 975). Dipstick test results (negative, trace, positive) were allocated to three levels of UACR (<30, 30-300, >300), respectively. In accordance with Kidney Disease Improving Global Outcomes CKD prognosis heat mapping, the cohort was classified into four risk grades (green: grade 1; yellow: grade 2; orange: grade 3, red: grade 4) based on baseline eGFR and UACR levels or dipstick tests. During the mean follow-up period of 5.6 years, 708 new onset cardiovascular events were recorded. For CKD identified by eGFR and dipstick testing (d...
BMC Nephrology, 2021
Background Albuminuria is an established risk marker for both cardiovascular and renal outcomes. In this study, we expected to use portable and inexpensive test strips to detect urine albumin level for risk stratification in cardiovascular and renal outcomes among rural Thai community. Objective To evaluate the relationship between urine albumin dipstick and cardiovascular and renal complications in rural Thai population. Methods We conducted a retrospective study in 635 rural Thai adults who tested urine albuminuria by using commercial urine albumin dipstick and the Micral-albumin test II strips at baseline. The subjects were divided into normoalbuminuria (albumin 200 mg/L). We collected data on the incidences of primary composite outcomes including cardiovascular or renal morbidity and mortality. Incident density and cox regression were analyzed to evaluate the association between albuminuria status and primary composite outcome. Results During an average 14-year follow-up, 102 p...