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Microalbuminuria modifies the mortality risk associated with electrocardiographic ST-T segment changes
Gilles F H Diercks1, Hans L Hillege, Ad J van Boven
1Department of Clinical Pharmacology, University of Groningen, Groningen, The Netherlands. g.f.h.diercks@med.rug.nl
Journal of the American College of Cardiology
|October 24, 2002
Summary
Microalbuminuria combined with ST-T segment changes on electrocardiograms (ECGs) significantly increases mortality risk. This combination identifies individuals at higher risk for all-cause and cardiovascular death in the general population.
Area of Science:
- Cardiology
- Vascular Medicine
- Public Health
Background:
- ST-T segment changes on resting electrocardiograms (ECGs) are known predictors of mortality.
- However, their prognostic value is limited in general populations with low cardiovascular risk.
Purpose of the Study:
- To determine if microalbuminuria enhances the prognostic ability of ST-T segment changes for mortality.
- To assess the combined impact on all-cause and cardiovascular mortality.
Main Methods:
- A population of 7,330 individuals was followed for a median of three years.
- ST-T segment changes were assessed using computerized Minnesota coding.
- Microalbuminuria was defined as urinary albumin excretion between 30-300 mg/24h.
Main Results:
- The combination of ST-T segment changes and microalbuminuria showed a significantly higher hazard ratio (HR) for all-cause mortality (HR 8.6) compared to ST-T changes alone (HR 1.3).
- This combination also demonstrated a substantially higher HR for cardiovascular mortality (HR 24.5) versus ST-T changes alone (HR 4.4).
- These findings remained significant after adjusting for other cardiovascular risk factors.
Conclusions:
- Microalbuminuria can identify individuals with ST-T segment changes who are at increased risk of all-cause and cardiovascular mortality.
- This suggests microalbuminuria is a valuable marker for assessing vascular damage and predicting adverse outcomes.