title: Prognostic value of albuminuria on 1-month mortality in acute myocardial infarction.
abstract: BACKGROUND
  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.
  
  
  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 (<20, 20-200, and >200 microg/min). Among survivors on day 2, 52% (625/1,211) of patients had an albuminuria level <20 microg/min, 39% (477) between 20 and 200 microg/min, and 9% (109) >200 microg/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 beta 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 microg/min had a 2.7-fold higher 30-day mortality, and those with >200 microg/min had an almost 4-fold higher 30-day mortality compared to those with albuminuria level of <20 microg/min. The addition of albuminuria information improved the discrimination capacity of the model and the global risk prediction.
  
  
  CONCLUSIONS
  Albuminuria level, taken as a quantitative or categorical variable, is an independent and powerful predictor of mortality after acute myocardial infarction.
authors.affiliation: Department of Cardiology, University Hospital Jean-Minjoz, Besançon, France. francois.schiele@univ-fcomte.fr
authors.forename: François
authors.initials: F
authors.lastname: Schiele
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meneveau
authors.forename: Romain
authors.initials: R
authors.lastname: Chopard
authors.forename: Vincent
authors.initials: V
authors.lastname: Descotes-Genon
authors.forename: Joanna
authors.initials: J
authors.lastname: Oettinger
authors.forename: Marie France
authors.initials: MF
authors.lastname: Seronde
authors.forename: Florent
authors.initials: F
authors.lastname: Briand
authors.forename: Yvette
authors.initials: Y
authors.lastname: Bernard
authors.forename: Fiona
authors.initials: F
authors.lastname: Ecarnot
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bassand
mesh_terms: D000419:Albuminuria / Q000150:complications*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment