Prognostic value of albuminuria on 1-month mortality in acute myocardial infarction

• Published in: The American heart journal 2009-02, Vol.157 (2), p.327-333
• Main Authors: Schiele, François, MD, PhD, Meneveau, Nicolas, MD, PhD, Chopard, Romain, MD, Descotes-Genon, Vincent, MD, Oettinger, Joanna, MD, Seronde, Marie France, MD, Briand, Florent, MD, Bernard, Yvette, MD, Ecarnot, Fiona, MSc, Bassand, Jean-Pierre, MD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Albuminuria - complications; Anticoagulants; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Confidence intervals; Coronary heart disease; Female; France; Heart; Heart attacks; Hospitalization; Hospitals; Humans; Hypertension; Male; Medical sciences; Mortality; Myocardial Infarction - complications; Myocardial Infarction - mortality; Myocarditis. Cardiomyopathies; Older people; Population; Predictive Value of Tests; Prognosis; Registries; Risk Assessment; Statistical methods; Variables
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2008.09.018

Rationale An increase in albuminuria occurs in the early days after acute myocardial infarction. The aim of this study was to assess the relation between albuminuria and 30-day mortality, as well as its incremental predictive value, on top of established prognostic parameters. Methods and results Demographic, clinical, and biological characteristics at admission, as well as in-hospital treatments and 1-month survival, were recorded in 1,211 consecutive patients admitted for acute myocardial infarction. Albuminuria was assessed from an 8-hour overnight urine collection within the first 2 days using immunonephelemetry. The population was categorized into 3 groups according to albuminuria levels (200 μg/min). Among survivors on day 2, 52% (625/1,211) of patients had an albuminuria level 200 μg/min. High levels of albuminuria were associated with older age, peripheral vessel disease, systolic blood pressure, glucose, creatinine, troponin, B-type natriuretic peptide, and high-sensitivity C reactive protein levels, as well as use of angiography, angiotensin-converting enzyme inhibitors, and β blockers. At 1 month, there was a significantly higher mortality rate in groups with higher albuminuria. After adjustment for baseline characteristics, patients with albuminuria level of >20 μg/min had a 2.7-fold higher 30-day mortality, and those with >200 μg/min had an almost 4-fold higher 30-day mortality compared to those with albuminuria level of