Profile of Non-Diabetic patients with Microalbuminuria in Acute Coronary Syndrome: A hospital based study

Abstract

Background and Aims: Microalbuminuria (MA) (urinary albumin excretion of 30-299 mg/d in a 24 hours collection or 30-299 μg/mg creatinine in a spot collection) is well accepted marker of micro and macrovascular damage in patients with diabetes mellitus and is considered as a surrogate marker for endothelial dysfunction in diabetic and non-diabetic patients. This study has been undertaken to investigate the prevalence of microalbuminuria among non-diabetic Acute Coronary Syndrome (ACS) patients.
 Methods: A hospital based cross-sectional study of 100 consecutive non-diabetic ACS patients was done. Traditional risk factors (like smoking, hypertension, dyslipidemia, obesity) of coronary artery disease were studied for the association with microalbuminuria in study subjects. Investigations were carried out in all the cases as per proforma and entered in the SPSS software for analysis.
 Results: The prevalence of microalbuminuria in non-diabetic ACS patients in the study was 73% which was statistically significant (p=0.04). A statistically significant higher prevalence of microalbuminuria was seen with different presentations of ACS; being highest (81.96%) in NSTEMI followed by STEMI (63.15%) and Unstable Angina (55%). It was found to be significant with the history of smoking (81.25%, p=0.013) and hypertension (82.25%, p=0.013). No significant association was found with age, body mass index (BMI) and dyslipidemia. A statistically significant higher prevalence of microalbuminuria was seen with increasing number of risk factors.
 Conclusion: There is increased prevalence of microalbuminuria in ACS patents. MA was associated with statistically higher number of cases with history of smoking and hypertension and presence of increasing number of risk factors.

Microalbuminuria as a Predictor of Outcome in Non-Diabetic Patients Undergo Percutaneous Coronary Intervention for Acute Coronary Syndrome

“…Memon and Kolachi (14) in their study on relationship of MA in non-diabetic and non-hypertensive patients with acute myocardial infarction found MA in 53.17% STEMI and in 15.8% NSTEMI. In contraste, Paudel et al (7) found that the prevalence of MA was highest in NSTEMI group being 81.96%. The corresponding figures in STEMI and unstable angina were 63.15% and 55% respectively.…”

“…Li et al (9) found that 80.9% were men. Paudel et al (7) investigated the prevalence of microalbuminuria among 100 non-diabetic acute coronary syndrome (ACS) patients and found that 68 were males while 32 were females with male: female = 2.12.…”

“…Hypertension was present in 33.3% (duration 1.4 ± 3.1 years) and smoking in 52% (no of cigarettes 14.4 ± 17.3, duration 9.9 ± 13.7 years). Paudel et al (7) found that 98 out of 100 ACS patients were having one or more risk factors, 64 patients with history of smoking and 62 patients with hypertension.…”

“…Regarding MA, there was no statistically significant difference between the three studied groups. However, Paudel et al (7) divided their patients into three groups; majority of patients had NSTEMI: 61% (no=61), 20% (no=20) had UA and 19% (no=19) had STEMI. Overall prevalence of MA was 73% (P-value=0.04).…”

“…They concluded a strong relationship between MA and the severity of CAD. Paudel et al (7) concluded that there is increased prevalence of microalbuminuria in ACS patents. MA was associated with statistically higher number of cases with history of smoking and hypertension and presence of increasing number of risk factors.…”