open access

Vol 23, No 3 (2016)
CLINICAL CARDIOLOGY Original articles
Published online: 2015-10-21
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Single spot albumin to creatinine ratio: A simple marker of long-term prognosis in non-ST segment elevation acute coronary syndromes

Claudio Cesar Higa, Fedor Anton Novo, Ignacio Nogues, Maria Graciana Ciambrone, Maria Sol Donato, Maria Jimena Gambarte, Natalia Rizzo, Maria Paula Catalano, Eugenio Korolov, Pablo Dino Comignani
DOI: 10.5603/CJ.a2015.0075
·
Pubmed: 26503079
·
Cardiol J 2016;23(3):236-241.

open access

Vol 23, No 3 (2016)
CLINICAL CARDIOLOGY Original articles
Published online: 2015-10-21

Abstract

Background: Microalbuminuria is a known risk factor for cardiovascular morbidity and mortality suggesting that it should be a marker of endothelial dysfunction. Albumin to creatinine ratio (ACR) is an available and rapid test for microalbuminuria determination, with a high correlation with the 24-h urine collection method. There is no prospective study that evaluates the prognostic value of ACR in patients with non ST-segment elevation acute coronary syndromes (NSTE-ACS). The purpose of our study was to detect the long-term prognostic value of ACR in patients with NSTE-ACS.

Methods: Albumin to creatinine ratio was estimated in 700 patients with NSTE-ACS at admission. Median follow-up time was 18 months. The best cutoff point of ACR for death or acute myocardial infarction was 20 mg/g. Twenty-two percent of patients had elevated ACR.

Results: By multivariable Cox regression analysis, ACR was an independent predictor of the clinical endpoint: odds ratio 5.8 (95% confidence interval [CI] 2–16), log-rank 2 p < 0.0001 in a model including age > 65 years, female gender, diabetes mellitus, creatinine clearance, glucose levels at admission, elevated cardiac markers (troponin T/CK-MB) and ST segment depression. The addition of ACR significantly improved GRACE score C-statistics from 0.69 (95% CI 0.59–0.83) to 0.77 (95% CI 0.65–0.88), SE 0.04, 2 p = 0.03, with a good calibration with both models.

Conclusions: Albumin to creatinine ratio is an independent and accessible predictor of long-term adverse outcomes in NSTE-ACS, providing additional value for risk stratification.

Abstract

Background: Microalbuminuria is a known risk factor for cardiovascular morbidity and mortality suggesting that it should be a marker of endothelial dysfunction. Albumin to creatinine ratio (ACR) is an available and rapid test for microalbuminuria determination, with a high correlation with the 24-h urine collection method. There is no prospective study that evaluates the prognostic value of ACR in patients with non ST-segment elevation acute coronary syndromes (NSTE-ACS). The purpose of our study was to detect the long-term prognostic value of ACR in patients with NSTE-ACS.

Methods: Albumin to creatinine ratio was estimated in 700 patients with NSTE-ACS at admission. Median follow-up time was 18 months. The best cutoff point of ACR for death or acute myocardial infarction was 20 mg/g. Twenty-two percent of patients had elevated ACR.

Results: By multivariable Cox regression analysis, ACR was an independent predictor of the clinical endpoint: odds ratio 5.8 (95% confidence interval [CI] 2–16), log-rank 2 p < 0.0001 in a model including age > 65 years, female gender, diabetes mellitus, creatinine clearance, glucose levels at admission, elevated cardiac markers (troponin T/CK-MB) and ST segment depression. The addition of ACR significantly improved GRACE score C-statistics from 0.69 (95% CI 0.59–0.83) to 0.77 (95% CI 0.65–0.88), SE 0.04, 2 p = 0.03, with a good calibration with both models.

Conclusions: Albumin to creatinine ratio is an independent and accessible predictor of long-term adverse outcomes in NSTE-ACS, providing additional value for risk stratification.

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Keywords

microalbuminuria, acute coronary syndromes, prognosis

About this article
Title

Single spot albumin to creatinine ratio: A simple marker of long-term prognosis in non-ST segment elevation acute coronary syndromes

Journal

Cardiology Journal

Issue

Vol 23, No 3 (2016)

Pages

236-241

Published online

2015-10-21

DOI

10.5603/CJ.a2015.0075

Pubmed

26503079

Bibliographic record

Cardiol J 2016;23(3):236-241.

Keywords

microalbuminuria
acute coronary syndromes
prognosis

Authors

Claudio Cesar Higa
Fedor Anton Novo
Ignacio Nogues
Maria Graciana Ciambrone
Maria Sol Donato
Maria Jimena Gambarte
Natalia Rizzo
Maria Paula Catalano
Eugenio Korolov
Pablo Dino Comignani

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