Microalbuminuria as an Independent Screening Tool in Patients with Myocardial Infarction

Abstract

Acute Myocardial Infarction (AMI) is a condition in which there is an inadequate supply of blood and oxygen to a portion of myocardium; most common cause being atherosclerosis of coronary vessels. Microalbuminuria (MAU) is defined as urinary albumin-to-creatinine ratio (UACR) of 30–300 mg/g. It is considered as marker of generalized endothelial dysfunction and vasculopathy and suggested to contribute to the formation of atherosclerotic lesion and ultimately leading to risk of cardiovascular disease (CVD). Hence, the study was planned to estimate and compare urinary albumin levels in the patients of AMI as compared to healthy control for risk stratification. A case control study involving 150 age (20–60 yrs.) and gender-matched subjects, admitted at the Surat Municipal Institute of Medical Education and Research (SMIMER) Hospital, Surat, India were divided into three groups. Group I comprised of 50 healthy subjects as control; Group II comprised of 70 patients diagnosed as AMI admitted to the ICCU & MICU; and Group III comprised of 30 patients diagnosed as having AMI accompanied by diabetes mellitus (DM). Urinary albumin and creatinine were analyzed and UACR was derived using these two parameters. In addition to these two parameters, serum total cholesterol, serum triacylglycerol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), total creatine phosphokinase (CPK) and CPK-MB were also analyzed. Results showed that the levels of HDL (40.07±9.20 mg%, p<0.05) were significantly low in Group II as compared to Group I. In Group III, UACR (48.04±12.5 mg/g, p<0.05), total cholesterol (208.34±52.98 mg%, p<0.001), triacylglycerol (197.34±89.41 mg%, p-0.002), LDL (190.95±82.27 mg%, p<0.05), total CPK (312.04±36.65 U/L, p-0.005) and CPK-MB (79.17±13.55 U/L, p-0.02) were significantly high as compared to Group I. Again in Group III, UACR (48.04±12.5 mg/g, p-0.03), LDL (190.95±82.27 mg%, p-0.005), total CPK (312.04±36.65 U/L, p-0.001) and CPK-MB (79.17±13.55 U/L, p-0.02) were significantly high as compared to Group II. A common type of pathogenesis was observed in case of MAU and MI and vascular endothelial dysfunction. There is also an evidence of high incidence of MAU in diabetic subjects. Due to this reason MAU can be independently used as a screening tool for predicting the risk of MI in patients, especially when it is associated with DM.

Keywords: Atherosclerosis, endothelial dysfunction, microalbuminuria (MAU), acute myocardial infarction (AMI), diabetes mellitus (DM)

Cite this Article

Kava DM, Lad HD, Kheni RS, et al. Microalbuminuria as an Independent Screening Tool in Patients with Myocardial Infarction. Research & Reviews: Journal of Medical Science and Technology. 2017; 6(2): 41–45p.