Effect of Urinary Albumin Creatinine Ratio on Cardiovascular Morbidity and Mortality in Diabetes Patients with Atherosclerotic Disease.
Diabetes Metab Syndr Obes
; 16: 819-828, 2023.
Article
em En
| MEDLINE
| ID: mdl-36959900
ABSTRACT
Background:
Diabetes mellitus (DM) patients with increased urinary albumin creatinine ratio (uACR) have higher risk of mortality, while it is unclear in DM patients with atherosclerotic cardiovascular disease (ASCVD).Methods:
We analysed 2832 DM patients with ASCVD in this multi-center registry cohort study Cardiorenal ImprovemeNt II (CIN-II) in 5 Chinese tertiary hospitals from 2007 to 2020. Patients were divided into 3 groups according to their uACR level (normal group uACR <30mg/g, moderately increased group 30mg/g≤ uACR <300mg/g, severely increased group 300mg/g≤ uACR). The main outcome of the study was cardiovascular mortality and all-cause mortality.Results:
During a median follow-up of 2.1 years, among 2832 patients (mean age 63.3 ± 9.9 years, 29.1% women), 434 patients (15.3%) had moderately increased uACR, and 203 patients (7.2%) had severely increased uACR. Compared to patients in normal group, patients had higher cardiovascular mortality in moderately increased group and severely increased group (2.5% vs 9.9% vs 16.7%, P < 0.001), as well as all-cause mortality. After adjusting confounders, the risk of cardiovascular mortality remained higher in moderately increased group (adjusted hazard ratio [aHR] 3.13; 95% confidence interval [CI] 2.04-4.81) and severely increased group (aHR 4.54; 95% CI 2.58-8.01) than in normal group, as well as all-cause mortality.Conclusion:
In our study, we found nearly a quarter of DM patients with ASCVD had increased uACR, and they have over 2- or 3-fold risk of cardiovascular mortality than those with normal uACR. UACR is a helpful indicator for risk stratification and treatment target for DM patients with ASCVD.
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MEDLINE
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En
Ano de publicação:
2023
Tipo de documento:
Article