A Study of Association of Microalbuminuria with Ischemic Heart Disease in Nondiabetic Patients: A Case–Control Study

Exclusion CriteriaPatients diagnosed with diseases causing excretion of albumin in urine such as diabetes mellitus, acute kidney injury, chronic kidney disease, acute decompensated heart failure, urinary tract infection, or eclampsia, and patients on prior therapy with ACE (angiotensin converting enzyme) inhibitors and/or ARBs (angiotensin receptor blockers), which decrease albuminuria, were excluded. Clinical Data and InvestigationsIschemic heart disease was diagnosed by evidence of any one or more of the following: myocardial infarction (ST elevation or non-ST elevation), presence of regional wall motion abnormality on transthoracic echocardiography, positive treadmill test, and complete or partial occlusion of vessels on coronary angiography.Clinically, we looked for bilateral pitting pedal edema and raised jugular venous pressure, and ventricular systolic or diastolic dysfunction on echocardiography was looked for to rule out congestive heart failure.History of diabetes mellitus, hypertension, and smoking (current or IntroductIonMicroalbuminuria is an amount of urinary albumin that is greater than the normal value but also lower than what is detected by a conventional dipstick.Thus, the rate of urine albumin excretion (UAE) in microalbuminuria is 30-300 mg/day. 1 Microalbuminuria is conventionally used as a marker of the onset of diabetic nephropathy.However, it is now also considered one of the risk factors for coronary artery disease (CAD). 2 Endothelial dysfunction and chronic low-grade inflammation, which cause increased transvascular leakage of macromolecules, result in microalbuminuria.The same endothelial dysfunction and chronic inflammation also causes CAD.So, there must lie an association between microalbuminuria and ischemic heart disease (IHD), irrespective of whether a patient is diabetic or not. 3 AIms A n d objectIvesTo evaluate whether microalbuminuria is associated with IHD in patients without diabetes mellitus. mAterIAls A n d methodsThis is a case-control study of 80 patients (40 cases and 40 controls) at SSG Hospital, Vadodara over a period of 6 months from November 2021 to April 2022, after approval from the institutional ethics committee and obtaining due consent.