What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Non-diabetic Acute Coronary Syndrome (n=100). Intervention: Microalbuminuria assessment. Primary outcome: Prevalence of microalbuminuria (p=0.04).

What does this research mean for the field?

Microalbuminuria is present in 73% of non-diabetic patients with acute coronary syndrome, with the highest prevalence observed in those with NSTEMI, and is significantly associated with smoking and hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 14, 2019Open Access

Profile of Non-Diabetic patients with Microalbuminuria in Acute Coronary Syndrome: A hospital based study

NPN PaudelManipal College of Medical Sciences AMAbhishek MaskeyManipal College of Medical Sciences DKDipesh KarkiTribhuvan University

Key Result

Microalbuminuria was present in 73% of non-diabetic patients with acute coronary syndrome, with the highest prevalence (81.96%) observed in those with NSTEMI.

Study Design

Type

Cross-Sectional (n=100)

Multicenter

Structured PICO

What is the prevalence of microalbuminuria and its association with traditional risk factors in non-diabetic patients with acute coronary syndrome?

Population

100 consecutive non-diabetic patients with Acute Coronary Syndrome (STEMI, NSTEMI, Unstable Angina) admitted to Manipal Teaching Hospital. Exclusions: known diabetes, random blood sugar ≥200mg/dl, microalbuminuria >300µg/mg creatinine, serum creatinine >1.5mg/dl, pyuria, history of preexisting congestive cardiac failure.

Outcome

Prevalence of microalbuminuria (urinary albumin excretion of 30-299 μg/mg creatinine in a spot collection)surrogate

Microalbuminuria is highly prevalent (73%) in non-diabetic patients with acute coronary syndrome, particularly those with NSTEMI, and is significantly associated with smoking, hypertension, and an increasing number of cardiovascular risk factors.

Main Result

p-value: p=0.04

Limitations

Small sample size of 100 patients
Results need to be substantiated with prospective larger clinical studies

Abstract

Background and Aims: Microalbuminuria (MA) (urinary albumin excretion of 30-299 mg/d in a 24 hours collection or 30-299 μg/mg creatinine in a spot collection) is well accepted marker of micro and macrovascular damage in patients with diabetes mellitus and is considered as a surrogate marker for endothelial dysfunction in diabetic and non-diabetic patients. This study has been undertaken to investigate the prevalence of microalbuminuria among non-diabetic Acute Coronary Syndrome (ACS) patients. Methods: A hospital based cross-sectional study of 100 consecutive non-diabetic ACS patients was done. Traditional risk factors (like smoking, hypertension, dyslipidemia, obesity) of coronary artery disease were studied for the association with microalbuminuria in study subjects. Investigations were carried out in all the cases as per proforma and entered in the SPSS software for analysis. Results: The prevalence of microalbuminuria in non-diabetic ACS patients in the study was 73% which was statistically significant (p=0.04). A statistically significant higher prevalence of microalbuminuria was seen with different presentations of ACS; being highest (81.96%) in NSTEMI followed by STEMI (63.15%) and Unstable Angina (55%). It was found to be significant with the history of smoking (81.25%, p=0.013) and hypertension (82.25%, p=0.013). No significant association was found with age, body mass index (BMI) and dyslipidemia. A statistically significant higher prevalence of microalbuminuria was seen with increasing number of risk factors. Conclusion: There is increased prevalence of microalbuminuria in ACS patents. MA was associated with statistically higher number of cases with history of smoking and hypertension and presence of increasing number of risk factors.

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