In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
Abstract:
Elevated albuminuria, a marker of endothelial renal damage, is a risk factor for cardiovascular events in the general population and in patients with diabetes or hypertension. We report here on its association with mortality in a large population of patients with chronic HF. Albuminuria (albumin/creatinine concentration ratio in a morning spot sample, UACR) was determined in 2131 patients with chronic HF enrolled in 77 centers participating to the GISSI-HF trial. Patients were divided according to normal (UACR 〈 30 mg/g) and abnormal urinary excretion of albumin (≥30 mg/g). Association between elevated albuminuria and all-cause mortality was tested by univariable and multivariable analyses. Elevated albuminuria was found in 25.3% of the population (age 67±11 y, 78.9% males, 30.1% NYHA class III-IV, 55.5% hypertension, 26.1% diabetes) and was more frequent in older patients, those with reduced renal function, diabetes or high CRP. Mortality was significantly higher in patients with elevated albuminuria (20.1% at 1000 days) compared to normals (9.0%, p 〈 0.0001). Elevated albuminuria remained an independent risk factor for all-cause mortality (HR [95%CI] 1.47 [1.18 –1.82] ) in a Cox model adjusted for clinical risk factors such as age, gender, NYHA class, renal function, diabetes, BMI and blood pressure. About a quarter of the patients enrolled in the GISSI-HF trial had abnormal urinary albumin excretion, a marker for both renal and systemic vascular disease. We show for the first time in a large representative sample that elevated albuminuria is an independent predictor of all-cause mortality in patients with chronic HF.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.118.suppl_18.S_866
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2008
detail.hit.zdb_id:
1466401-X
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