Key PointsQuestionWhat is the incremental prognostic value of urinary albumin excretion for cardiovascular risk assessment in patients with diabetes with and without the incorporation of cardiac biomarkers? FindingsIn this secondary analysis of a randomized clinical trial population of 15 760 patients with type 2 diabetes and high cardiovascular risk, there was a stepwise increased risk of cardiovascular events according to baseline urinary albumin to creatinine ratio. The association with increased risk was present even at low-level elevations of urinary albumin to creatinine ratio, which are otherwise considered normal, although this relationship was attenuated when adjusted for cardiac biomarkers. MeaningLow levels of albuminuria improve risk stratification for future cardiovascular risk in patients with type 2 diabetes; urinary albumin to creatinine ratio provides minimal incremental prognostic utility beyond cardiac biomarkers.
JAMA Cardiology – American Medical Association
Published: Feb 6, 2018
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