Background: The aim of this study was to examine whether the presence of
microalbuminuria (20-200 mu g/min) can predict in-hospital morbidity and
mortality in non-diabetic patients with acute myocardial infarction.
Methods: Two hundred twenty-three (172 men and 51 women) non-diabetic
patients with acute myocardial infarction were studied prospectively.
The main outcome measures of the study were based on a comparison of
in-hospital mortality and major non-fatal in-hospital events (pulmonary
edema, post-infarction angina, infarct extension, mechanical
complications, conduction disturbances and ventricular arrhythmias)
between microalbuminuric and normoalburninuric patients.
Results: A significant proportion of patients (33.6%) had
microalbuminuria. Seventy-six patients (34%) developed an in-hospital
event (fatal or non-fatal). Six patients (2.7%) with acute myocardial
infarction died in the hospital. Patients with microalbuminuria had a
higher mortality rate in comparison with normoalbuminuric patients
(6.6% vs. 0.68%, p=0.01). For non-fatal events, the incidence of
pulmonary edema and ventricular arrhythmias was significantly higher in
patients with microalbuminuria (14.6% vs. 3.4%, p < 0.001 and 12% vs.
3.4%, p=0.01, respectively). The combined end-point of the total number
of fatal and non-fatal events was significantly higher in patients with
microalbuminuria (57.3% vs. 22.3%,p < 0.001). In multiple logistic
regression analysis, microalbuminuria (p<0.001) and ejection fraction
(p=0.01) were independently related to the occurrence of major
in-hospital events.
Conclusions: Microalbuminuria is a significant predictor of in-hospital
morbidity and mortality in non-diabetic patients with acute myocardial
infarction. (c) 2005 Elsevier Ireland Ltd. All rights reserved
