Elevated urinary alpha1-microglobulin levels at hospital admission independently predicted increased all-cause in-hospital mortality in patients with STEMI (OR 1.109).
Cohort (n=1,854)
No
Does urinary Alpha1-microglobulin level at admission predict in-hospital mortality and MACEs in hospitalized patients with acute STEMI?
Urinary Alpha1-microglobulin measured at admission is an independent predictor of in-hospital mortality and adverse cardiac events in patients with acute STEMI.
Odds Ratio: 1.109 (95% CI 1.027–1.197)
Tasa de eventos absoluta: 4.4% vs 1%
valor p: p=0.008
BACKGROUND Alpha1-microglobulin (A1MG) is a small molecular protein related to oxidation and inflammation. It exists in diverse body fluids, including urine. Results from urine tests are sometimes neglected when predicting in-hospital prognosis. It remains unclear whether urinary A1MG (UA1MG) can predict short-term prognosis of ST-elevated myocardial infarction (STEMI). MATERIAL AND METHODS A total of 1854 hospitalized patients with acute STEMI were retrospectively enrolled in our study. Medical records were used to obtain patient demographic and clinical information, UA1MG values (which were used to divide patients into groups of low, medium, or high), and other laboratory parameters. Principal clinical outcomes of interest were all-cause in-hospital deaths, cardiac deaths, and major adverse cardiac events (MACEs). RESULTS Among the 1854 enrolled patients, 43 (2.3%) died in the hospital, of which 33 (1.8%) were cardiac deaths. MACEs were noted in 113 patients (6.1%) during hospitalization. The group with the highest UA1MG value showed a significantly higher frequency of in-hospital deaths, cardiac deaths, and MACEs, compared to those of the lowest UA1MG value group (4.4% vs. 1.0%, P<0.001; 3.1% vs. 0.6%, P<0.005; and 8.6% vs. 4.7%, P=0.007, respectively). Multivariate regression analysis revealed that UA1MG levels (odds ratio 1.109, 95% confidence interval (CI) 1.027-1.197, P=0.008) independently predicted all-cause in-hospital mortality. A UA1MG value of 3.23 mg/dL was considered as an optimal cutoff point in STEMI to predict all-cause mortality after receiver operating characteristic curve analysis (area under the curve 0.73, 95% CI 0.65-0.80, P<0.001). CONCLUSIONS The UA1MG value at hospital admission could be an independent prognostic factor of all-cause in-hospital mortality in patients with STEMI.
Cui et al. (Mon,) conducted a cohort in ST-Segment Elevation Myocardial Infarction (STEMI) (n=1,854). Urinary Alpha1-Microglobulin (UA1MG) vs. Low UA1MG levels was evaluated on All-cause in-hospital mortality (OR 1.109, 95% CI 1.027-1.197, p=0.008). Elevated urinary alpha1-microglobulin levels at hospital admission independently predicted increased all-cause in-hospital mortality in patients with STEMI (OR 1.109).