Background The aim of this study is to evaluate the significance of
microalbuminuria (MA) as a 3-year prognostic index in nondiabetic
patients with acute myocardial infarction (AMI).
Methods One hundred seventy-five patients with AMI were followed
prospectively for 3 years. The study end point was cardiac death or
rehospitalization for an acute coronary event.
Results Forty-two patients (24%) developed a new cardiac event during
the follow-up. Microalbuminuria (P < .001), pulmonary edema during
initial hospitalization (P < .001) and postinfarction angina (P =
.0364), advanced age (P = .001), severe atherosclerosis (high Gensini
score) (P = .036), ejection fraction <50% (P = .0013), history of
bypass surgery (P = .0265), and early conservative management (P = .021
A) were all associated with adverse prognosis. Cox proportional hazards
regression analysis showed that MA was an independent predictor of
3-year adverse prognosis in all the models tested, with an adjusted
relative risk for the development of a cardiac event ranging from 2.1 to
4.3.
Conclusions In nondiabetic patients with AMI, MA is a strong and
independent predictor of an adverse cardiac event within the next 3
years
