Impact of Microalbuminuria on Incident Coronary Heart Disease, Cardiovascular and All-cause Mortality: a Meta-analysis of Prospective Studies

Overview

Journal Int J Clin Exp Med

Specialty General Medicine

Date 2015 Mar 19

PMID 25784968

Citations 17

Authors

Fang Xia

Guanghua Liu

Yifu Shi

Yan Zhang

Affiliations

Soon will be listed here.

Abstract

This study is to investigate the magnitude of relationship between microalbuminuria and incident coronary heart disease (CHD) and mortality in the general population by conducting a meta-analysis. A comprehensive literature search in Pubmed and Embase database was performed prior to March 2014. Only prospective studies investigating the presence of microalbuminuria and incident CHD, cardiovascular disease (CVD), and mortality and were selected. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated by the presence of microalbuminuria versus without microalbuminuria. Finally, we identified 8 prospective studies involving 114,105 individuals. Participants with microalbuminuria were associated with 69% greater risk of CVD (RR=1.69; 95% CI 1.41-2.02) and 41% greater risk of CHD (RR=1.41; 95% CI 1.17-1.69). Participants with microalbuminuria were also associated with 57% greater risk of cardiovascular mortality (RR=1.57; 95% CI 1.20-2.06) and 65% greater risk of all-cause mortality (RR=1.65; 95% CI 1.45-1.88). Microalbuminuria is an independent predictor for CHD, CVD, and all-cause mortality in the general population. Early detection of microalbuminuria in the general population is likely to identify patients at increased risk of CVD and mortality.

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References

Gerstein H, Mann J, Yi Q, Zinman B, Dinneen S, Hoogwerf B . Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA. 2001; 286(4):421-6. DOI: 10.1001/jama.286.4.421. View

Ko G, So W, Chan N, Chan W, Tong P, Li J . Prediction of cardiovascular and total mortality in Chinese type 2 diabetic patients by the WHO definition for the metabolic syndrome. Diabetes Obes Metab. 2005; 8(1):94-104. DOI: 10.1111/j.1463-1326.2005.00475.x. View

Neil A, Hawkins M, Potok M, Thorogood M, Cohen D, Mann J . A prospective population-based study of microalbuminuria as a predictor of mortality in NIDDM. Diabetes Care. 1993; 16(7):996-1003. DOI: 10.2337/diacare.16.7.996. View

Casiglia E, Zanette G, Mazza A, Donadon V, Donada C, Pizziol A . Cardiovascular mortality in non-insulin-dependent diabetes mellitus. A controlled study among 683 diabetics and 683 age- and sex-matched normal subjects. Eur J Epidemiol. 2000; 16(7):677-84. DOI: 10.1023/a:1007673123716. View

Begg C, Mazumdar M . Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994; 50(4):1088-101. View

Diercks G, van Boven A, Hillege H, Janssen W, Kors J, de Jong P . Microalbuminuria is independently associated with ischaemic electrocardiographic abnormalities in a large non-diabetic population. The PREVEND (Prevention of REnal and Vascular ENdstage Disease) study. Eur Heart J. 2000; 21(23):1922-7. DOI: 10.1053/euhj.2000.2248. View

Scheven L, van der Velde M, Lambers Heerspink H, de Jong P, Gansevoort R . Isolated microalbuminuria indicates a poor medical prognosis. Nephrol Dial Transplant. 2013; 28(7):1794-801. DOI: 10.1093/ndt/gft031. View

Houlihan C, Tsalamandris C, Akdeniz A, Jerums G . Albumin to creatinine ratio: a screening test with limitations. Am J Kidney Dis. 2002; 39(6):1183-9. DOI: 10.1053/ajkd.2002.33388. View

Ovbiagele B . Microalbuminuria: risk factor and potential therapeutic target for stroke?. J Neurol Sci. 2008; 271(1-2):21-8. DOI: 10.1016/j.jns.2008.04.007. View

10.

Stroup D, Berlin J, Morton S, Olkin I, Williamson G, Rennie D . Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000; 283(15):2008-12. DOI: 10.1001/jama.283.15.2008. View

11.

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

12.

Yuyun M, Khaw K, Luben R, Welch A, Bingham S, Day N . A prospective study of microalbuminuria and incident coronary heart disease and its prognostic significance in a British population: the EPIC-Norfolk study. Am J Epidemiol. 2004; 159(3):284-93. DOI: 10.1093/aje/kwh037. View

13.

Cao J, Biggs M, Barzilay J, Konen J, Psaty B, Kuller L . Cardiovascular and mortality risk prediction and stratification using urinary albumin excretion in older adults ages 68-102: the Cardiovascular Health Study. Atherosclerosis. 2007; 197(2):806-13. DOI: 10.1016/j.atherosclerosis.2007.07.029. View

14.

Bigazzi R, Bianchi S, Nenci R, Baldari D, Baldari G, Campese V . Increased thickness of the carotid artery in patients with essential hypertension and microalbuminuria. J Hum Hypertens. 1995; 9(10):827-33. View

15.

Yuyun M, Khaw K, Luben R, Welch A, Bingham S, Day N . Microalbuminuria independently predicts all-cause and cardiovascular mortality in a British population: The European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) population study. Int J Epidemiol. 2004; 33(1):189-98. DOI: 10.1093/ije/dyh008. View

16.

Mykkanen L, Zaccaro D, OLeary D, Howard G, Robbins D, Haffner S . Microalbuminuria and carotid artery intima-media thickness in nondiabetic and NIDDM subjects. The Insulin Resistance Atherosclerosis Study (IRAS). Stroke. 1997; 28(9):1710-6. DOI: 10.1161/01.str.28.9.1710. View

17.

Hillege H, Fidler V, Diercks G, van Gilst W, de Zeeuw D, Van Veldhuisen D . Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation. 2002; 106(14):1777-82. DOI: 10.1161/01.cir.0000031732.78052.81. View

18.

Jensen J, Borch-Johnsen K, Feldt-Rasmussen B, Appleyard M, Jensen G . Urinary albumin excretion and history of acute myocardial infarction in a cross-sectional population study of 2,613 individuals. J Cardiovasc Risk. 1997; 4(2):121-5. View

19.

Romundstad S, Holmen J, Kvenild K, Hallan H, Ellekjaer H . Microalbuminuria and all-cause mortality in 2,089 apparently healthy individuals: a 4.4-year follow-up study. The Nord-Trøndelag Health Study (HUNT), Norway. Am J Kidney Dis. 2003; 42(3):466-73. DOI: 10.1016/s0272-6386(03)00742-x. View

20.

Wachtell K, Ibsen H, Olsen M, Borch-Johnsen K, Lindholm L, Mogensen C . Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy: the LIFE study. Ann Intern Med. 2003; 139(11):901-6. DOI: 10.7326/0003-4819-139-11-200312020-00008. View