Microalbuminuria: A strong predictor of 3-year adverse prognosis in nondiabetic patients with acute myocardial infarction

Koulouris, Spyridon; Lekatsas, Ioannis; Karabinos, Ilias; Ioannidis, Georgios; Katostaras, Theofanis; Kranidis, Athanasios; Triantafillou, Konstantinos; Thalassinos, Nikolaos; Anthopoulos, Lambros

doi:10.1016/j.ahj.2004.07.031

« Previous Next »American Heart Journal
Volume 149, Issue 5 , Pages 840-845, May 2005

Microalbuminuria: A strong predictor of 3-year adverse prognosis in nondiabetic patients with acute myocardial infarction

Spyridon Koulouris, MD, PhD
- 1st Cardiology Department, “Evangelismos Hospital,” Athens, Greece
- Reprint requests: Spyridon N. Koulouris, MD, PhD, Kekropos 64, 151 25 Marousi, Athens, Greece.
Ioannis Lekatsas, MD, PhD
- 1st Cardiology Department, “Evangelismos Hospital,” Athens, Greece
Ilias Karabinos, MD, PhD
- 1st Cardiology Department, “Evangelismos Hospital,” Athens, Greece
Georgios Ioannidis, MD, PhD
- Department of Endocrinology, Diabetes and Metabolism, “Evangelismos Hospital,” Athens, Greece
Theofanis Katostaras, PhD
- Faculty of Nursing, University of Athens, Athens, Greece
Athanasios Kranidis, MD, PhD
- 1st Cardiology Department, “Evangelismos Hospital,” Athens, Greece
Konstantinos Triantafillou, MD
- 1st Cardiology Department, “Evangelismos Hospital,” Athens, Greece
Nikolaos Thalassinos, MD, PhD
- Department of Endocrinology, Diabetes and Metabolism, “Evangelismos Hospital,” Athens, Greece
Lambros Anthopoulos, MD, PhD
- Athens Medical Center, Athens, Greece

Received 14 March 2004; accepted 27 July 2004.

Background

The aim of this study is to evaluate the significance of microalbuminuria (MA) as a 3-year prognostic index in nondiabetic patients with acute myocardial infarction (AMI).

Methods

One hundred seventy-five patients with AMI were followed prospectively for 3 years. The study end point was cardiac death or rehospitalization for an acute coronary event.

Results

Forty-two patients (24%) developed a new cardiac event during the follow-up. Microalbuminuria (P < .001), pulmonary edema during initial hospitalization (P < .001) and postinfarction angina (P = .0364), advanced age (P = .001), severe atherosclerosis (high Gensini score) (P = .036), ejection fraction <50% (P = .0013), history of bypass surgery (P = .0265), and early conservative management (P = .0214) were all associated with adverse prognosis. Cox proportional hazards regression analysis showed that MA was an independent predictor of 3-year adverse prognosis in all the models tested, with an adjusted relative risk for the development of a cardiac event ranging from 2.1 to 4.3.