Study on relevance of microalbuminuria of diabetics and coronary artery disease
LAI Ying JIANG Beihu JIN Huigen ZHAO Deqiang LIU Zongjun Department of Cardiology,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China
Objective To investigate whether microalbuminuria(MA)could be related to the severity of cor- onary artery disease(CAD)in type 2 diabetic mellitus and prediction of its prognosis.Methods From June 2003 to June 2004,one hundred and two diabetic patients with CAD were tested for microalbuminuria,taking 30-200 mg/L as positive,＜30 mg/L as negative.According to Judkins selective coronarial artery angiography,vascular narro- wing＞50% was considered to be CAD,otherwise as negative.Correlation between MA and severity of coronary artery disease as well as cardiac events during the first year follow-up was evaluated.Results In MA positive group,CAD was documented in 43 cases;in negtive MA group,CAD was present in 8 only;showing statistical significance (P＜0.01).The sensitivity sepecificity and positive predictability of diagnosing CAD in diabetic pa- tients with positive MA were 84.3%,72.8% and 81.4%,respectively.In patients with B+C lesions of the coro- nary arteries,the positive rate of MA compared to patients with type A lesions showed no significant difference sta- tistically (P＞0.05),but somehow rather higher,(93.8% vs 68.4%).The same changes occurred in multi-vessel and single-vessel lesions.Follow up was made in the 2 groups for (12.1±1.8) month,the occurrence of unstable angina,ischemic target vessel recanalization and complex end point events in diabetic patients with positive MA were significantly higher than those in the MA-negative group.(P＜0.01).The results were much influenced in se- lective patients treated by PCI and bypass surgery,and also compliance to standard medical treatment.Conclusion The incidence of CAD is much higher in type 2 diabetic mellitus positive MA and increasing tendency of cardiac events.
【CateGory Index】： R587.1;R541.4