Elevated urine albumin creatinine ratio linked to CV mortality in CAD patients with T2DM
In a recent study entitled, "Elevated urine albumin creatinine ratio increases cardiovascular mortality in coronary artery disease patients with or without type 2 diabetes mellitus: a multicenter retrospective study", Dr Xueqin Lin et al. and colleagues investigated whether mildly elevated Urine albumin creatinine ratio (uACR) can increase the risk of mortality in patients with the history of Coronary artery disease or CAD patients and whether diabetes status influences the risk. In this investigation, they found that with the elevation of uACR level, there is an increased incidence and risk of cardiovascular mortality and all-cause mortality among CAD patients. They highlighted that among type 2 diabetes patients, this risk is more significant.
The elevation increases the risk by nearly 1.5 fold even if the uACR level is within the normal range (recommended by guidelines).
The study is published in Cardiovascular Diabetology.
It is already known that Albuminuria is an atherosclerotic risk factor among the general population. There needs to be more research on the amplification of this association in CAD patients ad whether diabetes mellitus confounds the association.
In this study, we aimed to analyse the prognosis of elevated uACR in the CAD population with/without T2DM in 5,960 patients with CAD. These Patients were divided into two groups, T2DM and non-T2DM groups, and baseline uACR levels were assessed on three grades (low: uACR < 10 mg/g, middle: 10 mg/g ≤ uACR < 30 mg/g, and high: uACR ≥ 30 mg/g).
Cardiovascular mortality and all-cause mortality were the endpoints of the study.
The main results of the study are:
- In 2.2 years of follow-up, 310 patients constituting 5.2 % died.
- Out of these patients, 4 % patients died due to cardiovascular disease.
- Those with elevated uACR had a higher risk of cardiovascular mortality than those with low uACR and all-cause mortality.
- In non-diabetes patients, elevated uACR increased nearly 1.5-fold risk of cardiovascular mortality.
- In diabetes patients, the risk of cardiovascular mortality increased by 1.5- fold to 3- fold risk.
Concluding further, they said mild elevations in uACR increase cardiovascular mortality risk in CAD patients, especially T2DM patients.
They highlighted that uACR is a readily available and valuable prognostic indicator that deserves attention among CAD patients.
The limitations of the study were related to incomplete data, inaccuracy, short observational period and bias.
Further reading:
https://cardiab.biomedcentral.com/articles/10.1186/s12933-023-01907-3
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