MESA: Increased risk for coronary artery calcification in patients with microalbuminuria

Asymptomatic individuals demonstrated an increased risk for incident coronary artery calcification, as well as greater coronary artery calcification progression, among those with microalbuminuria, according to the findings of a prospective cohort analysis of participants in the MESA study.

The MESA study included 6,814 self-identified white, African-American, Hispanic or Chinese participants who were free of clinical CVD at entry. Of the 6,775 individuals with available urine albumin data, researchers excluded those who had macroalbuminuria or were missing follow-up coronary artery calcification (CAC) data, leaving them with the final study population of 5,666 participants.

At baseline, individuals with microalbuminuria were more likely to have CAC >0 compared with those without microalbuminuria (62% vs. 48%, P<.0001). During a mean follow-up of 2.4 years, patients with microalbuminuria and no CAC at baseline compared with those without microalbuminuria in demographic-adjusted analyses were more likely to develop CAC (RR=2.05; 95% CI, 1.41-3.02). After multivariant adjustment, the relationship was attenuated but remained significant (RR=1.76; 95% CI, 1.19-2.61). Additionally, among those with CAC at baseline, those with microalbuminuria vs. those without had a 15-volume-units higher median increase in CAC in demographic adjusted analyses.

“This large, population-based study demonstrates an increased risk of incident CAC as well as greater CAC progression among those with microalbuminuria,” the researchers wrote. “Further study is needed to determine the degree to which macroalbuminuria precedes and predicts progression of atherosclerosis and how this information can be used to reduce CV events.”

Previous CARDIOLOGY TODAY coverage of results and analyses from the MESA study can be found here.

DeFilippis A. J Am Coll Cardiol Img. 2010;3:595-604.

Follow CardiologyToday.com on Twitter.