Premium
Relationship of mildly increased albuminuria and coronary artery revascularization outcomes in patients with diabetes
Author(s) -
Siddique Ayesha,
Murphy Timothy P.,
Naeem Syed S.,
Siddiqui Efaza U.,
Pencina Karol M.,
McEnteggart Gregory E.,
Sellke Frank W.,
Dworkin Lance D.
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27890
Subject(s) - medicine , albuminuria , cardiology , diabetes mellitus , myocardial infarction , coronary artery disease , percutaneous coronary intervention , hazard ratio , type 2 diabetes , revascularization , conventional pci , population , kidney disease , endocrinology , confidence interval , environmental health
Background The aim of this study was to examine the relationship of albuminuria to cardiovascular disease outcomes in diabetic patients undergoing treatment for stable coronary artery disease. Methods and results We analyzed data from 2176 participants of the Bypass Angioplasty Revascularization Investigation in type‐2 diabetes (BARI‐2D) trial, a randomized clinical trial comparing Percutaneous coronary intervention/Coronary artery bypass grafting (PCI/CABG) to medical therapy for people with diabetes. The population was stratified by baseline spot urine albumin–creatinine ratio (uACR) into normal (uACR <10 mg/g), mildly (uACR ≥10 mg/g < 30 mg/g), moderately (uACR ≥30 mg/g < 300 mg/g) and severely increased (uACR ≥300 mg/g) groups, and outcomes compared between groups. Death, myocardial infarction (MI) and/or stroke were experienced by 489 patients at a mean follow‐up of 4.3 ± 1.5 years. Compared with normal uACR, mildly increased uACR was associated with a 1.4 times ( P = 0.042) increase in all‐cause mortality. Additionally, nonwhites with type‐II diabetes and stable coronary artery disease who had mildly increased albuminuria had a Hazard ratio (HR) of 3.3 times ( P = 0.028) for cardiovascular death, 3.1 times for ( P = 0.002) all‐cause mortality, and two times for ( P = 0.015) MI during follow‐up. Conclusions Mildly increased albuminuria is a significant predictor of all‐cause mortality in those with type‐II diabetes mellitus and stable coronary artery disease, as well as for cardiovascular events those who are nonwhites.