A place to move your ideas

Un posto dove muovere le tue idee

Giuseppe Berton, Rocco Cordiano, Sebastian Mbaso, Renzo De Toni, Paolo Mormino and Paolo Palatini

Objective To assess the risk of mortality associated withhypertension and microalbuminuria in patients with acutemyocardial infarction.

Design A prospective study.

Setting Intensive care units in three Italian generalhospitals.

Patients In total 309 consecutive patients (including 97women) aged 66.6 ± 12.5 years, admitted to hospital foracute myocardial infarction.

Main outcome measures Albumin excretion ratemeasured by radioimmunoassay of 24 h urine samples,on the first and third days after admission to hospital. In-hospital mortality rate among the patients stratifiedaccording to their history of hypertension and albuminexcretion rate.

Results Of the patients, 147 had histories ofhypertension. Forty-four per cent of the normotensive and43% of the hypertensive subjects had microalbuminuriaon the first day. On the third day the percentages were25 and 29%, respectively. Twenty-two patients diedbefore discharge from hospital. Patients were dividedinto four groups according to whether they hadmicroalbuminuria or not and likewise for hypertension.Mortality rate among the subjects with hypertension and microalbuminuria combined was greater than thoseamong the other three groups (P< 0.0001 on the firstand third days). The relative hazard ratio was 11.7 on thefirst day, and 15.6 on the third day. In a multivariate Cox’smodel hypertension and microalbuminuria combined hada greater predictive power for mortality than eithervariable alone. Killip class, age, and creatinine kinasesMB level were other significant predictors of death. ConclusionsThese results show that the combination of hypertension and microalbuminuria is associated witha greater risk of in-hospital mortality among subjectswith acute myocardial infarction, independently of degreeof heart failure and other possible confounders.

J Hypertension, 1998, 16;525-530.

Keywords myocardial infarction, hypertension, albumin excretion rate, in-hospital mortality

Welcome

In 1992, a small group of medical researchers and other participants embarked on an project to investigate new clinical factors for heart disease, studying patients with acute coronary syndrome and following them for many years. Today, the observations on the long-term survival after acute coronary syndrome are internationally acknowledged. Main results appears on the most important cardiovascular texts across the world. The study is called “the ABC heart disease study”.

Nel 1992, un piccolo gruppo di medici ricercatori ed altri operatori sanitari, iniziarono un progetto per studiare nuovi fattori clinici della malattia cardiaca, studiando pazienti con sindrome coronarica acuta e seguendoli per molti anni. Oggi, ciò che è stato osservato sulla sopravvivenza a lungo temine dopo sindrome coronarica acuta è riconosciuto a livello internazionale. I principali risultati appaiono sui maggiori testi di medicina cardiovascolare in tutto il mondo. Questo progetto è stato chiamato “the ABC heart disease study”.

Mission

The Mission of the ABC Study on Heart Disease Project is to promote the knowledge on heart disease chiefly based on the long-term follow up of the patients. And to promote citizen health supporting preventive, social, and sport activities.