Urinary Albumin Excretion and Severity of Coronary Artery Disease by Coronary Angiography in Patients with Type 2 Diabetes

Abstract Background: Coronary Artery Disease (CAD) is a major cause of death in developed and developing countries. Many of CAD patients don't have any other classic risk factor except diabetes. The aim of this study was to investigate the relation-ship between urinary albumin excretion and severity of coro-nary artery lesion by coronary angiography in type 2 diabetic patients.
Patients and Methods: This study, conducted with 200 type 2 diabetic patients with documented CAD by coronary angiography. The ratio of urinary albumin to creatinine was calculated. The study populations were classified according to albumin to creatinine ratio, Group I: Normoalbuminuric group (120 diabetic patients), Group II (80 patients) and subdivided into Group II a (56 microalbuminuria patients), Group II b (24 macroalbuminuria patients). The severity of CAD was estimated using multi-vessel affection and SYNTAX score. Results: The prevalence of triple vessel CAD was signif-icantly higher in Group II (microalbuminuic and macroalbu-minuric patients). Triple vessel CAD was present in 13.3% of patients in Group I (normoalbuminuric), whereas it was present in 62.5% of patients in Group II (p<0.001). Left main artery stenosis was present in 8.3% in Group I and 20% in Group II (p=0.03). Of patients, 16.6% and 70% in Group I and II had Ostial and Para ostial stenosis respectively (p<0.001). Major side branch stenosis was present in 20% of patients in Group I and in 90% of patients Group II (p<0.001). The severity of CAD by SYNTAX score revealed that, patients of Group II had higher SYNTAX scores compared to Group I (29±8 vs. 16-}6, p<0.001). Patients with macroalbuminuria had higher SYNTAX scores compared to those with micro-albuminuria (30±3 vs. 26-}6, p=0.001). Multivariate logistic regression analysis found smoking, dyslipidemia and albu-minuria were risk factors for coronary artery lesion (p=0.004, p<0.001 and p<0.01 respectively).
Conclusion: Patients with microalbuminuria and mac-roalbuminuria have more extensive and severe angiographic CAD compared to those with normoalbuminuria.