Author + information
- Wassef Karrowni,
- Yan Li,
- Philip Jones,
- Sharon Cresci,
- Mouin Abdallah,
- Thomas Maddox,
- John Spertus and
- Phillip Horwitz
Previous studies examining the association of albuminuria (AL) with outcomes in acute myocardial infarction (AMI) patients may be confounded by inaccuracies in urine protein testing at the time of AMI. We assessed the relation of AL, measured 1 month after AMI, as a risk factor for adverse outcomes and studied its interaction with diabetes status.
882 patients from the 24-center TRIUMPH registry had urinary albumin creatinine ratio (UACR) measured 1 month after hospitalization with AMI. Patients were stratified into 4 groups based on AL (defined as UACR ≥30 µg/mg) and diabetes status. After propensity adjustment for differences in patient characteristics, including creatinine clearance (CrCl), we estimated 1 month to 3 years all-cause mortality.
AL was present in 100/561 (17.8%) of non-diabetic and 133/321 (41.1%) of diabetic patients. Figure 1shows the 3-year survival Kaplan-Meier estimates for various subgroups. Using sequential proportional hazards regression, hazard ratios for the association between AL and 3-year mortality were 1.78 (1.08, 2.94) for the overall cohort, 1.44 (0.70, 2.96) for diabetics, and 2.20 (1.07, 4.54) for non-diabetics (p=0.86 for interaction between the association of AL with mortality and diabetes status).
AL assessed 1 month after AMI is associated with long-term mortality in diabetics and non-diabetics, even after adjusting for CrCl and other risk factors. This could be a technique for restratifying risk in post-AMI patients.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Biomarkers and Cardiovascular Risk
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1303-215
- 2013 American College of Cardiology Foundation