Correlation of Severity of Coronary Artery Disease with Urine Microalbumin in Indian subjects using Gensini score

  • Dr Kiran VH Junior resident Department of Internal Medicine KMC Mangalore, India
  • Dr Mahadevaswamy BC Junior resident Department of Internal Medicine KMC Mangalore, India
  • Dr Padmanabha kamath Associate professor, Department of Cardiology, KMC Mangalore, India
Keywords: Gensini score, Coronary artery disease, Microalbuminuria

Abstract

Background: Microalbuminuria is one of the simple and independent risk factor for Coronary artery disease. The study was aimed to study the severity of Coronary artery disease with degree of Microalbuminuria using Gensini scoring.

Methodology: Our study consisted of 233 subjects admitted for coronary angiography .All subjects were asked detailed medical history mainly concentrating on important risk factors like Diabetes, Hypertension and physical examination was thoroughly carried out; detection of urine Microalbumin and Coronary angiography was carried on. Gensini scoring was used to assess the severity of CAD.

Results: Out of 233 subjects which were studied, 140 were diabetics (60.1%). 95% of Diabetics had abnormal Gensini score, which is statistically significant (p=0.004<0.01), 84% of Non diabetic subjects had abnormal Gensini score (suggests CAD), with odds ratio 3.6 (CI 1.4 to 9.3). Diabetics had a mean age of 60years and Non Diabetics is 58years in our study. There was good correlation between Microalbuminuria and Gensini score with r= +0.510 (p=0.0001) and also good correlation between Diabetes duration and Gensini score with r= +0.626 (p=0.0001).

Conclusion: Severity of CAD as assessed by Gensini score was higher in patients with higher microalbuminuria.

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References

1. Rayner M, Petersen S. European cardiovascular disease statistics. British Heart Foundation health promotion research group. Oxford, United Kingdom: department of public health, university of oxford, 2000.

2. Stehouwer CD, Henry RM, Dekker JM, Nijpels G, Heine RJ, Bouter LM. Microalbuminuria is associated with impaired brachial artery, flow-mediated vasodilatation in elderly individuals without and with diabetes: Further evidence for a link between microalbuminuria and endothelial dysfunction –The Hoorn Study. Kidney Int Suppl 2004 Nov;( 92):S42-4. [PubMed]

3. Quyyumi AA. Prognostic value of endothelial function. Am J Cardiol. 2003 Jun 19;91(12A):19H-24H. [PubMed]

4. Adler AI, Boyko EJ, Ahroni JH, Smith DG. Lower extremity amputation in diabetes. The independent effects of peripheral vascular disease sensory neuropathy and foot ulcers. Diabetes care.1999Jul;22(7):1029-35. [PubMed]

5. Karalliedde J, Viberti G. Microalbuminuria and cardiovascular risk. Am J Hypertens. 2004 Oct;17(10):986-93. [PubMed]

6. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983 Feb;51(3):606. [PubMed]

7. Jager A , Kostense PJ, Ruhe HG, Heine RJ, Nijpels G, Dekker JM, et al. Microalbuminuria and peripheral arterial disease are independent predictors of cardiovascular and all- cause mortality especially among hypertensive subjects: five year follow up of the Hoorn study. Arterioscler Thromb Vasc Biol. 1999 Mar;19(3):617-24. [PubMed]

8. Deveci OS, Kabakci G, Tulumen E, Okutucu S, Aksoy H, et al. The relationship between micoalbuminuria and the presence and extent of coronary atherosclerosis. Angiology. 2010 Feb;61(2):184-91. [PubMed]

9. Sukhija R, Aronow WS, Kakar P, Garza L, Sachdeva R, Sinha A, Mehta JL. Relation of microalbuminuria and coronary artery disease in patients with and without diabetes mellitus. Am J Cardiol. 2006 Aug 1;98(3):279-81. Epub 2006 Jun 6. [PubMed]

10. Berton G, Cordiano r, Palmieri R, Cucchini F, De Toni R, Palatine P . Microalbuminuria during acute myocardial infarction : a strong predictor for 1-year mortality. Eur Heart J. 2001 Aug;22(16):1466-75. [PubMed]

11. Gerstein HC, Mann JF, Yi Q, et al. Albuminuria and risk of cardiovasccular events, death, and and heart failure in diabetic and nondiabetic individuals. JAMA. 2001 Jul 25;286(4):421-6. [PubMed]

12. Brantsma AH, Bakker SJ, Hillege HL, De Zeeuw D, De jong PE, Gansevoort RT. Urinary albumin excretion and its relation with C- reactive protein and the metabolic syndrome in the prediction of type 2. Diabetes Care. 2005 Oct;28(10):2525-30. [PubMed]

13. Romundstad S, Holmen J, Kvenild K, Hallan H, Ellekjaer H. Microalbuminuria and all cause mortality in 2089 apparently healthy individuals a 4.4 year follow up study.the Nord-Trondelag Health Study (HUNT), norway. Am J Kidney Dis. 2003 Sep;42(3):466-73. [PubMed]

14. Yuyun MF, Khaw KT, Luben R et al. 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 Feb;33(1):189-98.

15. Klausen K, Borch-Johnsen K, Feldt-Rasmussen B, Jensen G, Clausen P, Scharling H, Appleyard M, Jensen JS. Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes. Circulation. 2004 Jul 6;110(1):32-5.

16. DeFilippis AP, Kramer HJ, Katz R, Wong ND, Bertoni AG, et al. Association between coronary artery calcification progression and microalbuminuria: the MESA study. JACC Cardiovasc Imaging. 2010 Jun;3(6):595-604.

17. Guo LX, Ma J, Cheng Y, Zhang LN, Li M. Urinary albumin excretion rate is correlated with severity of coronary artery disease in elderly type 2 diabetic patients. Chin Med J(Engl) 2012 Dec;125(23):4181-4.
CITATION
DOI: 10.17511/jmrr.2015.i6.109
Published: 2015-07-31
How to Cite
1.
VH K, BC M, kamath P. Correlation of Severity of Coronary Artery Disease with Urine Microalbumin in Indian subjects using Gensini score. Int J Med Res Rev [Internet]. 2015Jul.31 [cited 2024Nov.22];3(6):579-82. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/283
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Original Article