Urine albumin creatinine ratio predicts cardiovascular events

Urine albumin creatinine ratio predicts cardiovascular events

Urine albumin creatinine ratio (UACR) is known to predict cardiovascular events. Elevated urine albumin creatinine ratio would mean at least low grade albuminuria, indicating endothelial dysfunction. Endothelial dysfunction in this setting is linked with intrinsic myocardial dysfunction.

In those with heart failure, increased UACR is associated with increased cardiovascular mortality and higher rates of hospitalization for heart failure [1]. As it is known that increased albuminuria might be a marker for various pathophysiological changes in patients with heart failure, the authors assessed the prevalence and prognostic value of a spot UCAR in patients with heart failure. Baseline UCAR and follow up values were measured in 2310 patients in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) Programme. Both microalbuminuria and macroalbuminuria were noted. The predictive value of UCAR for the primary composite outcomes of death from cardiovascular causes or admission to hospital with worsening heart failure as well as death from any cause were assessed.

It was finally concluded that UCAR is a powerful and independent predictor of prognosis in heart failure.

Reference

1. Colette E Jackson, Scott D Solomon, Hertzel C Gerstein, Sofia Zetterstrand, Bertil Olofsson, Eric L Michelson, Christopher B Granger, Karl Swedberg, Marc A Pfeffer, Salim Yusuf, John J V McMurray, CHARM Investigators and Committees. Albuminuria in chronic heart failure: prevalence and prognostic importance. Lancet. 2009;374:543–550.