Microalbuminuria in hypertensive nondiabetic patients with ST elevation myocardial infarction

• Published in: Journal of cardiovascular medicine (Hagerstown, Md.) Vol. 11; no. 10; pp. 748 - 753
• Main Authors: Lazzeri, Chiara, Valente, Serafina, Chiostri, Marco, PIcariello, Claudio, Gensini, Gian F
• Format: Journal Article
• Language: English
• Published: United States Italian Federation of Cardiology 01-10-2010
• Subjects: Aged; Aged, 80 and over; Albuminuria - epidemiology; Albuminuria - mortality; Albuminuria - urine; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - mortality; Arrhythmias, Cardiac - epidemiology; Blood Glucose - metabolism; Chi-Square Distribution; Female; Hospital Mortality; Humans; Hyperglycemia - epidemiology; Hypertension - epidemiology; Hypertension - mortality; Hypertension - urine; Incidence; Insulin Resistance; Italy - epidemiology; Logistic Models; Male; Middle Aged; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Myocardial Infarction - urine; Pulmonary Edema - epidemiology; Risk Assessment; Risk Factors; Treatment Outcome; Italy
• ISSN: 1558-2027; 1558-2035
• DOI: 10.2459/JCM.0b013e32833acd00

OBJECTIVESPrevious investigations on microalbuminuria in acute myocardial infarction have been performed in heterogeneous populations of hypetensive/nonhypertensive, diabetic/nondiabetic patients, submitted to either thrombolysis or mechanical revascularization or not revascularized. Therefore, the aim of our investigation was to assess, in 242 consecutive hypertensive patients with ST elevation myocardial infarction without previously known diabetes, all submitted to mechanical revascularization, whether microalbuminuria, in the early phase, has a prognostic role for in-hospital mortality or complications (acute pulmonary edema and arrhythmias).
METHODSThe study population was divided into two groups according to microalbuminuria excretiongroup A (microalbuminuria within the normal range); group B (microalbuminuria above the normal range).
RESULTSThe incidence of microalbuminuria was 52.1% (126/242). No significant difference was detectable in the incidence of in-hospital mortality and complications between the two groups. Patients with microalbuminuria exhibit a larger infarct size as indicated by higher values of troponin I. Microalbuminuria was associated with higher values of glucose and a higher prevalence of insulin resistance.
CONCLUSIONIn ST elevation myocardial infarction hypertensive patients without previously known diabetes, all submitted to mechanical revascularization, microalbuminuria is a common finding but it does not yield prognostic information about in-hospital mortality or complications. Interestingly it was associated with acute glucose dysmetabolism (as inferred by hyperglycemia and the prevalence of insulin resistance), thus suggesting that it can be considered part of the acute metabolic response to the acute coronary event.