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

BACKGROUND: Albuminuria is one of the abnormalities in diabetics. Although different studies have shown its relationship with cardiovascular diseases, few studies have been performed to show the relationship between albuminuria level and coronary artery disease (CAD) severity. This study was thus designed in order to assess the relationship between the albuminuria and the severity of CAD. METHODS: In this cross-sectional study, 164 (80 male and 84 female) non-insulin dependent diabetes mellitus patients with angina pectoris were included. All patients were hospitalized for diagnostic or therapeutic angiography in Chamran Hospital, Isfahan, Iran. First morning urine samples were taken from all participants to calculate protein to creatinine (Pr/Cr) ratio. The standard angiography video was assessed by three cardiologists through Seldinger method. CAD was scores from zero to 21 based on the Extent method. The relationship between CAD severity and urine Pr/Cr ratio was assessed by bivariate correlational methods and multivariate analysis. SPSS15 was used for all data analyses. RESULTS: Among the 164 studied patients, mean levels of morning urine protein was and creatinine were 22.77 ± 30.99 and 0.07 ± 0.04, respectively. Urine Pr/Cr ratio was 760.94 ± 401.56 mg/g (median: 181.02). Mean CAD score was equal to 13.34 ± 6.24. There was no correlation between urine Pr/Cr ratio and CAD severity (P = 0.778; r = 0.022). In multivariate analysis model controlled for age, gender, fasting blood sugar, captopril consumption, and history of hypertension and hyperlipidemia, increased urine Pr/Cr ratio led to increased CAD severity (P = 0.021). CONCLUSION: Albuminuria level measured based on morning urine Pr/Cr ratio might be an independent risk factor for the severity of CAD. It can thus predict the severity of Cad. These findings signify the importance of albuminuria diagnosis and treatment.