title: Early clinical implications of microalbuminuria in patients with acute ischaemic stroke.
abstract: BACKGROUND
  Microalbuminuria is thought to be independently associated with an increased risk of, and mortality from, stroke. However, no studies have shown whether microalbuminuria is associated with the early clinical outcomes of acute ischaemic stroke. Therefore we investigated whether this. We also looked at radiological outcomes in stroke patients with microalbuminuria.
  
  
  METHODS
  This was a retrospective study of patients with ischaemic stroke (within 72 h of symptom onset) who had been consecutively admitted to the Cerebrovascular Center at Chonnam National University Hospital between May 2010 and February 2011. Early clinical outcomes were assessed by early neurological deterioration (END) and modified Rankin Scale score >2 at discharge. In addition, early radiological outcomes were assessed from haemorrhagic transformation (HT) and lesion changes on follow-up diffusion-weighted imaging. We categorised a urine albumin/creatinine ratio of ≤30 mg albumin/g creatinine as normal and 30-300 mg albumin/g creatinine as microalbuminuria.
  
  
  RESULTS
  139 of 361 patients (38.5%) had microalbuminuria. In multivariate analysis, microalbuminuria was independently associated with END and HT. Furthermore, there were significant relationships between urinary albumin/creatinine ratio and white matter hyperintensity (WMH) grades (31.78 mg albumin/g creatinine for no WMH, 48.41 for grade 1, 64.29 for grade 2, and 44.16 for grade 3; p=0.004) and the types of HT (37.43 mg albumin/g creatinine for no HT, 71.41 for HI, and 131.63 for PH; p<0.001).
  
  
  CONCLUSIONS
  In the early phase of ischaemic stroke, patients with microalbuminuria were associated with worse clinical and radiological outcomes (END, HT and lesion changes on follow-up diffusion-weighted imaging) than those without.
authors.affiliation: Department of Neurology, Chonnam National University Medical School, Dong-ku, Gwangju, Korea.
authors.forename: Bang-Hoon
authors.initials: BH
authors.lastname: Cho
authors.forename: Joon-Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: Jane
authors.initials: J
authors.lastname: Chang
authors.forename: Kang-Ho
authors.initials: KH
authors.lastname: Choi
authors.forename: Tai-Seung
authors.initials: TS
authors.lastname: Nam
authors.forename: Seong-Min
authors.initials: SM
authors.lastname: Choi
authors.forename: Seung-Han
authors.initials: SH
authors.lastname: Lee
authors.forename: Man-Seok
authors.initials: MS
authors.lastname: Park
authors.forename: Byeong-Chae
authors.initials: BC
authors.lastname: Kim
authors.forename: Myeong-Kyu
authors.initials: MK
authors.lastname: Kim
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Cho
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications*; D015415:Biomarkers / Q000652:urine; D002545:Brain Ischemia / Q000209:etiology*; D003404:Creatinine / Q000652:urine; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine