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A prospective two-center study on the associations between microalbuminuria, coronary atherosclerosis and long-term clinical outcome in asymptomatic patients with type 2 diabetes mellitus: evaluation by coronary CT angiography

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Abstract

This study assessed the associations between microalbuminuria in asymptomatic patients with type 2 diabetes and the presence, extent, and severity of coronary atherosclerosis, as measured by coronary computed tomography angiography (CCTA), and the long-term clinical outcomes. In total, the study enrolled 284 consecutive eligible asymptomatic patients with type 2 diabetes and without known coronary artery disease (CAD), who then underwent CCTA and 24 h urine albumin measurements. Microalbuminuria was defined as 30–300 mg/day urinary albumin excretion. Obstructive CAD, as measured by CCTA, was defined as maximum intra-luminal stenosis ≥50 %. Patients with and without microalbuminuria were compared in terms of obstructive CAD prevalence, and the extent and severity of coronary atherosclerosis. They were evaluated using the following data: coronary artery calcium score (CACS), atheroma burden obstructive score (ABOS), segment involvement score (SIS) and segment stenosis score (SSS). All-cause mortality within a follow-up period of 5 years was also compared. Compared to patients without microalbuminuria, patients with microalbuminuria were more likely to have obstructive CAD (p = 0.004). Microalbuminuria was associated with higher ABOS (p = 0.010), SIS (p = 0.029), and SSS (p = 0.011), except for CACS (p = 0.058). Multivariable analyses adjusted for conventional cardiovascular risk factors revealed that microalbuminuria was an independent predictor of obstructive CAD [odds ratio 2.255, confidence intervals (CI) 1.121–4.538, p = 0.023] and all-cause mortality (hazard ratio 3.469, CI 1.319–9.121, p = 0.012). In asymptomatic patients with type 2 diabetes, microalbuminuria was associated with increased risk of CAD and poorer clinical outcomes.

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Authors and Affiliations

  1. Cardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Banpodong 505, Seochogu, Seoul, 137-701, Republic of Korea

    Jin-Jin Kim, Ik Jun Choi, Eun-Ho Choo, Sungmin Lim, Pum-Joon Kim, Ki-Bae Seung & Kiyuk Chang

  2. Cardiovascular Center and Cardiology Division, St. Paul’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Byung-Hee Hwang

  3. Cardiovascular Center and Cardiology Division, Uijeongbu St Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea

    Yoon-Seok Koh & Jong Min Lee

  4. Division of Endocrinology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Seung-Hwan Lee & Jae-Hyung Cho

  5. Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Banpodong 505, Seochogu, Seoul, 137-701, Republic of Korea

    Jung Im Jung

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  1. Jin-Jin Kim
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Correspondence to Jung Im Jung or Kiyuk Chang.

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Kim, JJ., Hwang, BH., Choi, I.J. et al. A prospective two-center study on the associations between microalbuminuria, coronary atherosclerosis and long-term clinical outcome in asymptomatic patients with type 2 diabetes mellitus: evaluation by coronary CT angiography. Int J Cardiovasc Imaging 31, 193–203 (2015). https://doi.org/10.1007/s10554-014-0541-6

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  • DOI: https://doi.org/10.1007/s10554-014-0541-6

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