Early clinical implications of microalbuminuria in patients with acute ischaemic stroke
- Bang-Hoon Cho1,
- Joon-Tae Kim1,
- Jane Chang1,
- Kang-Ho Choi1,
- Tai-Seung Nam2,
- Seong-Min Choi2,
- Seung-Han Lee2,
- Man-Seok Park2,
- Byeong-Chae Kim1,
- Myeong-Kyu Kim1,
- Ki-Hyun Cho1
- 1Department of Neurology, Cerebrovascular Center, Chonnam National University Medical School, Gwangju, Korea
- 2Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Jeonnam, Korea
- Correspondence to Dr Joon-Tae Kim, Department of Neurology, Chonnam National University Medical School, 8 Hak-dong, Dong-ku, Gwangju 501-757, Korea;
Contributors Study concept and design: J-TK, B-HC. Acquisition of data: J-TK, B-HC. Analysis and interpretation of data: J-TK, B-HC. Drafting of the manuscript: J-TK, B-HC, JC. Critical revision of the manuscript for important intellectual content: JC, M-SP, K-HC, K-HCho, S-HL, S-MC, M-KK, B-CK, T-SN. Statistical analysis: J-TK, B-HC. Administrative, technical or material support: K-HCho, M-SP, S-HL, S-MC, T-SN.
- Received 29 March 2012
- Accepted 5 July 2012
- Published Online First 2 August 2012
Background Microalbuminuria is thought to be independently associated with an increased risk of, and mortality from, stroke. However, no studies have shown whether microalbuminuria is associated with the early clinical outcomes of acute ischaemic stroke. Therefore we investigated whether this. We also looked at radiological outcomes in stroke patients with microalbuminuria.
Methods This was a retrospective study of patients with ischaemic stroke (within 72 h of symptom onset) who had been consecutively admitted to the Cerebrovascular Center at Chonnam National University Hospital between May 2010 and February 2011. Early clinical outcomes were assessed by early neurological deterioration (END) and modified Rankin Scale score >2 at discharge. In addition, early radiological outcomes were assessed from haemorrhagic transformation (HT) and lesion changes on follow-up diffusion-weighted imaging. We categorised a urine albumin/creatinine ratio of ≤30 mg albumin/g creatinine as normal and 30–300 mg albumin/g creatinine as microalbuminuria.
Results 139 of 361 patients (38.5%) had microalbuminuria. In multivariate analysis, microalbuminuria was independently associated with END and HT. Furthermore, there were significant relationships between urinary albumin/creatinine ratio and white matter hyperintensity (WMH) grades (31.78 mg albumin/g creatinine for no WMH, 48.41 for grade 1, 64.29 for grade 2, and 44.16 for grade 3; p=0.004) and the types of HT (37.43 mg albumin/g creatinine for no HT, 71.41 for HI, and 131.63 for PH; p<0.001).
Conclusion In the early phase of ischaemic stroke, patients with microalbuminuria were associated with worse clinical and radiological outcomes (END, HT and lesion changes on follow-up diffusion-weighted imaging) than those without.
- early neurological deterioration
- early outcomes
- hemorrhagic transformation
- acute ischaemic stroke
- urine albumin-to-creatinine ratio
- white matter hyperintensity
Funding This study was supported by grants from the Korea Health Care Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065).
Competing interests None.
Ethics approval Ethics approval was provided by the institutional review board of Chonnam National University Hospital.
Provenance and peer review Not commissioned; externally peer reviewed.