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


CONCLUSIONS
In nondiabetic patients with AMI, MA is a strong and independent predictor of an adverse cardiac event within the next 3 years.
Koulouris
Spyridon
S
1st Cardiology Department, Evangelismos Hospital, Athens, Greece. skoulouris@ath.forthnet.gr
Lekatsas
Ioannis
I
Karabinos
Ilias
I
Ioannidis
Georgios
G
Katostaras
Theofanis
T
Kranidis
Athanasios
A
Triantafillou
Konstantinos
K
Thalassinos
Nikolaos
N
Anthopoulos
Lambros
L
D000368:Aged; D000419:Albuminuria / Q000652:urine*; D003920:Diabetes Mellitus; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality* / Q000652:urine*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors