J Korean Med Sci.  2013 Mar;28(3):409-414. 10.3346/jkms.2013.28.3.409.

Significance of Microalbuminuria in Relation to Subclinical Coronary Atherosclerosis in Asymptomatic Nonhypertensive, Nondiabetic Subjects

• Park HE
• Heo NJ
• Kim M
• Choi SY

• KMID: 1786939
• DOI: http://doi.org/10.3346/jkms.2013.28.3.409

Abstract

We aimed to investigate the significance of microalbuminuria and its relationship with subclinical atherosclerosis in nonhypertensive and nondiabetic patients, by using coronary artery computed tomography (CT). A total of 1,318 nonhypertensive and nondiabetic subjects who had taken coronary artery CT and measured spot urine albumin to creatinine ratio (UACR) were evaluated. The atherosclerotic changes of coronary arteries were greater in subjects with microalbuminuria, reflected by coronary artery calcium score (CACS) and significant coronary artery stenosis (CACS > or = 100 in 15.3% vs 7.6% and stenosis > or = 50% in 11.5% vs 4.9% of patients with vs without microalbuminuria, P = 0.008 and P = 0.011, respectively). Among various parameters that are known as a risk factor or possible biomarkers of coronary artery disease, presence of microalbuminuria, age and Framingham risk score were significantly related to coronary artery stenosis. Among them the presence of microalbuminuria showed stronger correlation than others to the coronary artery stenosis detected by CT, even after adjusting confounding factors (OR 3.397, 95% confidence interval 1.138 to 10.140, P = 0.028). The presence of microalbuminuria by UACR was significantly associated with presence of coronary artery stenosis > or = 50% in asymptomatic, nonhypertensive and nondiabetic general population. Our study suggests that the presence of microalbuminuria may imply subclinical coronary artery disease, even in asymptomatic population.

Keyword

Microalbuminuria; Coronary Artery; Tomography, X-Ray Computed

MeSH Terms

Adult
Age Factors
Aged
Albuminuria/*complications
Blood Pressure
Calcium/analysis
Coronary Artery Disease/complications/*radiography
Coronary Stenosis/complications
Coronary Vessels/chemistry
Creatinine/urine
Female
Humans
Male
Middle Aged
Odds Ratio
Retrospective Studies
Risk Factors
Sex Factors
Tomography, X-Ray Computed
Creatinine
Calcium

Figure

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  Fig. 1 Proportion of subjects with coronary atherosclerosis in patients with versus without microalbuminuria. Reflected by (A) coronary artery calcium score and (B) significant coronary artery stenosis (≥ 50%) (UACR,urine albumin to creatinine ratio; ▒, % of patients with UACR < 20 mg/g; █, % of patients with UACR 20-200 mg/g).

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