MICROALBUMINURIA: ASSOCIATION WITH ISCHAEMIC HEART DISEASE IN NON-DIABETICS

Authors

  • Rizwan Hashim
  • Shazia Nisar
  • Khalil ur Rehman
  • Naeem Naqi

Abstract

Background: In view of the high morbidity and mortality associated with ischemic heart disease(IHD), the estimation of individual cardiovascular risk over and above the assessment of classicrisk factors, such as age, hypercholesterolemia and hypertension, is an important prerequisite forfocusing preventive measures and therapeutic measures. Microalbuminuria (MA) as a marker ofIHD in nondiabetics is currently under international debate. The present descriptive studyundertaken at Combined Military Hospital, Lahore was aimed to determine the frequency of MAin nondiabetic IHD patients. Methods: One hundred consecutive non diabetic patients with IHD(73 males, 27 females). Patients showing clinical albumiuria and with other causes of proteinuriawere excluded. Urinary albumin in first morning sample was estimated by immunoturbidimetrymethod. Albumin to creatinine ratio (ACR) was calculated as mg/g. Results: The frequency ofMA ( ACR > 30 mg/g) was 37% in patients. Frequency was highest in older age bracket for bothgenders. The mean ACR was 131.8±66.2 mg/g. Significant difference was observed in mean MAlevel among different age groups. Conclusion: MA is common in nondiabetics patients with IHD.The mean level of MA was higher in older patients.Key Words: Ischemic heart disease, nondiabetics, microalbuminuria, cardiovascular risk.

References

Murray CJL, Lopez AD. The global burden of disease: a

comprehensive assessment of mortality and disability from

diseases, injuries, and risk factors in 1990 and projected to

Cambridge, Mass: Harvard University Press; 1996.

McGovern PG, Pankow JS, Shahar E, Doliszny KM, Folsom

AR, Blackburn H, et al. The Minnesota Heart Survey

Investigators. Recent trends in acute coronary heart disease:

mortality, morbidity, medical care, and risk factors. N Engl J

Med 1996; 334:884–90.

Yusuf S, Reddy S, Ôunpuu S, Anand S. Global burden of

cardiovascular diseases. Part II: Variations in cardiovascular

disease by specific ethnic groups and geographic regions and

prevention strategies. Circulation 2001; 104:2855 - 64.

Abbas S, Abbas S, Riaz A, Malik N. Risk factors for

coronary artery disease in Pakistan. Pak Armed Forces Med J

; 53(1):12-19.

Khan JA, Khan SP, Ahmed Z, Shah SH, Khaliq MA. Level

of hypercholesterolemia in patients admitted for heart

diseases: a pilot study. Pak J Med Res 2001; 40:18-9.

Nyuyen TT, Elleform RD, Hodge DO, Balles KR, Kolthe

TE, Abu-Leddhl. Lp (a) as a risk factor for cardiovascular

disease. Circulation 1997; 96: 1390-7.

J Ayub Med Coll Abbottabad 2006;18(1)

Ridker PM, Cushman M, Stampfer MJ, Tracy RP,

Hennekens CH. Inflammation, aspirin, and the risk of

cardiovascular disease in apparently healthy men. N Engl J

Med 1997; 336: 973–9.

Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive

protein and other markers of inflammation in the prediction

of cardiovascular disease in women. N Engl J Med 2000;

: 836–43.

MA J, Hennekens CH, Ridker PM, Stampfer MJ. A

prospective study of fibrinogen and risk of myocardial

infarction in the Physicians’ Health Study. J Am Coll Cardiol

; 33:1347-52.

Christen WG, Ajani UA, Glynn RJ, Hennekens CH. Blood

levels of homocysteine and increased risks of cardiovascular

disease: causal or casual? Arch Intern Med 2000; 160: 422–

Viberti GC, Thomas SM. Searching for new coronary heart

disease risk factors. Eur Heart J 2000; 21:1905-6.

Ali I, Khan I, Baloch MK, Mustafa G. Comparative lipd

profile studies in cardiac and diabetic patients. Pak J

Pharmaceut Sci 2004; 17:25-30.

Parving HH, Osterby R, Ritz E. Diabetic nephropathy. In:

Brenner BM, Levine S (edi). The Kidney. Philadelphia: WB

Saunders; 2000:1731-73.

Garg JP, Bakris GL. Microalbuminuria: marker of

cardiovascular dysfunction, risk factor for cardiovascular

disease. Vasc Med 2002; 7:35-43.

Hillege HL, Janssen WMT, Bak AAA, Diercks GFH,

Grobbee DE, Crijns HJGM et al. Microalbumniuria is

common, also in a nondiabetic, nonhypertensive population,

and an independent indicator of cardiovascular risk factors

and cardiovascular morbidity. J Inter Med 2001; 249:519-26.

Jensen JS. Microalbuminaria and the risk of atherosclerosis.

Clinical, epidemiological and physiological investigations.

Dan Med Bull 2000; 47(2):63-78.

Lloyd DR, Hindle EJ, Marples J, Gatt JA. Urinary albumin

measurements by immunoturbidimetry. Ann Clin Biochem

; 24:(Pt2) 209-10.

Yudkin JS, Forrest RD, Jackson CA. Microalbuminuria as

predictor of vascular disease in non-diabetic subjects.

Islington Diabetes Survey. Lancet 1988; ii: 530–3.

Ritz E, Nowicki M, Fliser D, Horner D, Klin HP. Proteinuria

and hypertension. Kidney Int 1994; 46 (Suppl 47):S76–80.

Cirillo M, Senigalliesi L, Laurenzi M, Alfieri R, Stamler J,

Stamler R et al. Microalbuminuria in non-diabetic adults:

relation of blood pressure, body mass index, plasma

cholesterol levels, and smoking: The Gubbio Population

Study. Arch Intern Med 1998; 158: 1933-9.

Taskiran M, Feldt-Rasmussen B, Jensen GB, Jensen JS.

Urinary albumin Excretion in hospitalized patients with acute

myocardial infarction. Scand Cardiovasc J 1998; 32:163-6.

Venkatt KK. Proteinuria and microalbuminuria in adults:

significance, evaluation and treatment. South Med J 2004;

(10):969-79.

Borch-Johnsen K, Feldt-Rasmussen B, Strandgaard S,

Schroll M, Jensen JS. Urinary albumin excretion. An

independent predictor of ischemic heart disease. Arterioscler

Thromb Vasc Biol 1999; 19:1992-7.

Damsgaard EM, Froland A, Jorgensen OD, Mogensen CE.

Microalbuminuria as predictor of increased mortality in

elderly people. BMJ 1990; 300: 297–300.

Jensen JS. Renal and systemic transvascular albumin leakage

in severe atherosclerosis. Arterioscler Thromb Vasc Biol

; 15: 1324-29.

Berton G, Cordiano R, Palmieri R, Cicchini F, DeToni R,

Palitini P. Microalbuminuria during acute myocardial

infarction. Eur Heart J 2001; 22:1466-1475

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