Microalbuminuria during acute myocardial infarction; a strong predictor for 1-year mortality.

Abstract:

AIMS:Urinary albumin excretion increases during acute myocardial infarction but little is known on the prognostic significance and the pathophysiological mechanisms of microalbuminuria in this clinical setting. The primary aim of the study was to examine whether urinary albumin excretion has predictive power for 1-year mortality after acute myocardial infarction. A secondary objective was to gain insight into the pathophysiological mechanisms of increased urinary albumin in myocardial infarction. METHODS AND RESULTS:This is a prospective cohort study conducted in three coronary care units (Northeast Italy). Four hundred and thirty-two unselected, consecutively enrolled patients with acute myocardial infarction (66.3+/- 12.3 years of age) were studied. The incidence of mortality was related to the baseline urinary albumin:creatinine ratio. The best cut-off for total mortality approximated to 50 mg x g(-1)on the first day after myocardial infarction, 30 mg x g(-1)on the third day, and to 20 mg x g(-1)on the seventh day. At multivariable Cox analysis, the albumin:creatinine ratio was the strongest among several independent predictors of mortality (adjusted relative risks: 3.6 (95% CI, 2.1--6.2) on the first day, 4.9 (95% CI, 2.9--8.2) on the third day and 4.0 (95% CI, 2.3--6.8) on the seventh day). Independent determinants of urinary albumin were plasma aldosterone on the first day, and inflammatory markers on the third and seventh days. CONCLUSION:Urinary albumin assessed in the first week after acute myocardial infarction is a strong prognostic marker for 1-year mortality.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Berton G,Cordiano R,Palmieri R,Cucchini F,De Toni R,Palatini P

doi

10.1053/euhj.2000.2582

subject

Has Abstract

pub_date

2001-08-01 00:00:00

pages

1466-75

issue

16

eissn

0195-668X

issn

1522-9645

pii

S0195668X0092582X

journal_volume

22

pub_type

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