Document Detail

Microalbuminuria in Non-Diabetic Stemi : An Independent Predictor for Acute Kidney Injury.
MedLine Citation:
PMID:  22694718     Owner:  NLM     Status:  Publisher    
Abstract Aims: To assess the impact of microalbuminuria on the development of acute kidney injury and to investigate its prognostic role at long term follow-up in 526 consecutive patients with ST elevation myocardial infarction without previously known diabetes. Methods: Microalbuminuria was measured using immunonephelemetry in the urine collected in the night Main Results: Patients with microalbuminuria were older (p= 0.013). They showed higher values of peak glycemia (p=0.017), peak Tn I (p<0.001), NT-pro BNP (p=0.020), ESR (p=0.003), CRP (p=0.020) and leukocyte count (p<0.001). Lower eGFR were observed in patients with microalbuminuria both on admission and during ICCU stay (p=0.048 and p=0.003, respectively). A positive correlation was observed between CRP and microalbuminuria (Spearman's rho 0.114, p=0.024).The composite end point was observed in seventy three patients (18 patients died and 59 pts developed acute kidney injury) At multivariable regression analysis microalbuminuria was an independent predictor of acute kidney injury. At follow-up [42.6 (25(th)-75(th) percentile 17.5 - 56.8) months], Kaplan-Meier curve analysis showed that patients with microalbuminuria had a lower survival rate in respect to patients without microalbuminuria. Cox regression analysis documented that microalbuminuria was an independent predictor of long term mortality (HR: 1.089; 97%CI 1.036 - 1.145; p<0.001) Conclusions: in a large series of STEMI patients without previously known diabetes submitted to PCI, microalbuminuria, as a marker of endothelial permeability following higher systemic inflammatory activation and larger infarct lesions, is an independent predictor for the development acute kidney injury. Furthermore, microalbuminuria identifies a subset of patients at higher risk for long term mortality.
Chiara Lazzeri; Serafina Valente; Marco Chiostri; Claudio Picariello; Paola Attanà; Gian Franco Gensini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-14
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  -     ISSN:  1651-2006     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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