Microalbuminuria Is Associated with Increased Risk of Death in Patients with Myocardial Infarction

In order to study the long-term effect of microalbuminuria on mortality among patients hospitalized with acute myocardial infarction, we followed 125 patients from 1996 to 2000. Exclusion criteria at baseline were renal or urinary tract disease, diabetes mellitus and acute coronary revascularization. At inclusion, urinary albumin/creatinine concentration ratio, height, weight, blood pressure, left ventricle ejection fraction by echocardiography, smoking status, medication, number of acute myocardial infarctions, age and sex were recorded. Deaths were traced in 2000 by means of the Danish Personal Identification Register. Microalbuminuria, defined as a urinary albumin/creatinine concentration ratio above 0.65 mg/mmol, occurred in 52% of the patients and was associated with increased all-cause mortality. Thus, 39% of the patients with microalbuminuria versus only 20% with normoalbuminuria had died within 4 years (p = 0.04). In logistic regression analyses, the odds ratio for death associated with microalbuminuria was 2.5 (1.2–5.6) (p = 0.03), whereas the age-adjusted odds ratio was 1.8 (0.8– 4.2) (p = 0.18). We conclude that the presence of microalbuminuria might be associated with an increased 4-year risk of death among hospitalized patients with myocardial infarction. This hypothesis should be tested in a major population of patients in order to verify the independence from other risk factors including age. Furthermore, we recommend microalbuminuria to be included in future trials in patients with myocardial infarction.