Can urine protein to creatinine ratio predict the severity of coronary artery disease?

BACKGROUND:Albuminuria is one of the abnormalities which occur in diabetics. Different studies have shown its relationship with cardiovascular diseases but few studies have been performed to show the relationship between albuminoria level and coronary artery disease (CAD) severity. This study was designed to asses the relationship between albuminuria and coronary artery disease severity. METHODS: In this cross-sectional study, the ۱۶۴ Non-Insulin Dependent Diabetes Mellitus patients with angina pectoris who hospitalized for diagnostic or therapeutic angiography in Isfahan Chamran hospital were included. Urine Pr/Cr ratio has been calculated in all patients, using the first sample of morning urine. The standard angiography video has been assessed by three cardiologists through Seldinger method. CAD score has been given from ۰ to ۲۱ based on Extent method. The relationship between CAD severity and urine Pr/Cr ratio has been assessed with bivariate correlation methods and multivariate analysis. RESULTS: In ۱۶۴ patients (males = ۸۰ & females = ۸۴) morning urine protein mean was ۲۲.۷۷ ± ۳۰.۹۹ and morning urine creatinin mean was ۰.۰۷ ± ۰.۰۴. Urine Pr/Cr ratio was ۷۶۰.۹۴ ± ۴۰۱.۵۶ mg/g and its median was ۱۸۱.۰۲. The CAD score was equal to ۱۳.۳۴ ± ۶.۲۴. There was no correlation between urine Pr/Cr ratio and CAD severity (P = ۰.۷۷۸, r = ۰.۰۲۲). In multivariate analysis , increased urine Pr/Cr ratio led to increased CAD severity by control of the age, FBS, gender, Captopril use, history of HTN and hyperlipidemia variables (P = ۰.۰۲۱). CONCLUSION: The amount of albuminuria which measured based on morning urine sample Pr/Cr ratio may be an independent risk factor for severity of CAD and can predict it. These findings signify the importance of albuminuria diagnosis and treatment. Key words: Severity, Coronary artery disease, Albuminuria, Angiography.