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Micro-albuminuria: a predictor of 7-day mortality in acute myocardial infarction

Sanjay K Bandyopadhyay1, Soumitra Ghosh, Ranjana Bandyopadhyay

  • 1Department of Medicine, Nil Ratan Sircar Medical College, Kolkata.

Journal of the Indian Medical Association
|June 14, 2011
PubMed

Insights

Microalbuminuria (MA) is highly prevalent in acute myocardial infarction (AMI) patients. Elevated or persistent MA strongly predicts short-term in-hospital mortality and correlates with poor cardiac function in AMI survivors.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Acute myocardial infarction (AMI) poses significant mortality risks.
  • Identifying reliable prognostic markers for in-hospital mortality is crucial for patient management.
  • Microalbuminuria (MA) is increasingly recognized as a potential indicator of endothelial dysfunction and cardiovascular risk.

Purpose of the Study:

  • To determine the prevalence of microalbuminuria (MA) in non-diabetic patients with acute myocardial infarction (AMI).
  • To investigate the significance of MA as a predictor of short-term in-hospital mortality.
  • To correlate MA with established prognostic markers like Killip's class and ejection fraction in AMI patients.

Main Methods:

  • A cohort of 80 non-diabetic AMI patients admitted within 24 hours of pain onset was studied.
  • Spot urinary albumin-to-creatinine ratio (ACR) was measured on days 1, 4, and/or 7.
  • Hemodynamic status (Killip's class) and ejection fraction were assessed, and 7-day mortality was recorded.

Main Results:

  • Microalbuminuria (MA) was detected in 95% of patients on day 1.
  • Higher MA values (>100 microg/mg) on day 1 were associated with significantly increased mortality (p <0.01).
  • Static or increasing MA from day 1 to day 4/7 correlated significantly with higher mortality (p <0.01) and deteriorating Killip's class.

Conclusions:

  • Microalbuminuria (MA) is a highly prevalent finding in acute myocardial infarction (AMI) patients.
  • MA is a reliable predictor of short-term in-hospital mortality in AMI.
  • MA levels correlate with impaired cardiac function and hemodynamic instability in AMI patients.

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