Prevalence, predictors and prognostic significance of microalbuminuria in acute cardiac patients: a single center experience.

The objective of this study was to prospectively assess the prevalence, predictors and prognostic significance of microalbuminuria in a large cohort of consecutive acute cardiac patients, admitted to an intensive cardiac care unit from 1 January 2008 to 30 June 2009. In 815 acute cardiac patients, microalbuminuria is detectable in 39.3%. Microalbuminuria shows a significant negative correlation with left ventricular ejection fraction (Spearman's ρ = -0.228; p < 0.001), while it is positively correlated with C-reactive protein (Spearman's ρ = 0.239; p < 0.001), NT-pro-BNP (Spearman's ρ = 0.306; p < 0.001) and glycemia (Spearman's ρ = 0.191; p < 0.001). Microalbuminuria is an independent predictor for in-hospital mortality (1 μg/min step) (OR 1.015; 95% CI 1.008-1.023; p < 0.001). In the acute phase of cardiac patients, microalbuminuria is a common finding, and it represents an independent predictor for early mortality. It is strictly linked to the inflammatory activation (as indicated by C-reactive protein) and to acute glucose values, thus suggesting that it may be part of the acute response to stress.