Microalbuminuria in patients with previous myocardial infarction

Microalbuminuria (MA) is a cardiovascular risk factor. The aim of this study was to examine the relationship between MA and the intima-media complex of the carotid and brachial artery, endothelial function, glucose metabolism, haemostatic variables and cardiac hypertrophy in patients with coronary heart disease. A total of 123 patients, aged 31-80 years, with a history of previous myocardial infarction and without known diabetes mellitus were examined with B-mode ultrasound of common carotid and brachial arteries, flow-mediated dilatation of the brachial artery and echocardiography. A standard oral glucose tolerance test with 75 g of glucose was performed. MA was defined as excretion of 20-200 mu g albumin/min. MA was present in 11% of patients. Patients with MA had significantly higher level of 2-h plasma glucose, a lower displacement of the atrioventricular plane, a thicker septum wall and a higher prevalence of impaired glucose tolerance test compared with patients with normoalbuminuria (P < 0.05). Urinary albumin excretion (UAE) was significantly and positively associated with calculated intima-media area (cIMa) in both brachial and common carotid arteries as well as with age and interventricular septum thickness. In conclusion, UAE was significantly and positively associated with cIMa in both the common carotid and the brachial arteries as well as with left ventricular septum thickness and glucose intolerance in patients with a history of previous myocardial infarction without known diabetes mellitus.