Prognostic value of microalbuminuria on admission in patients with acute pulmonary embolism

Abstract

Objective: There have been no studies examining the effect of microalbuminuria on outcomes of patients with acute pulmonary embolism (APE). This study aimed to assess the association between microalbuminuria and in-hospital mortality in patients with APE. Methods: This retrospective study included all adult patients hospitalized due to APE between June 2015 and May 2018. Blood and urine samples were collected before the diagnostic procedures on admission. Patients were divided into 3 groups according to urinary albumin to creatinine ratio (UACR) levels: normoalbuminuria (<30 mg/g), microalbuminuria (30–299 mg/g), and macroalbuminuria (> 300 mg/g). The primary endpoint of the study was in-hospital mortality. Results: A total of 154 consecutive patients (mean age 69.8 ± 13.4 years, 51.9% female) were included, and 21 (13.6%) of the patients died during their in-hospital course. The prevalence of normoalbuminuria, microalbuminuria, macroalbuminuria was 70.1%, 23.4%, and 6.5%, respectively. Patients with in-hospital mortality had significantly lower estimated glomerular filtration rate (eGFR), but higher UACR at admission than those patients who survived. As compared with patients with normoalbuminuria, multivariate analyses showed that the patients with microalbuminuria and macroalbuminuria had 2.38-, and 3.48-fold higher risk for in-hospital mortality, respectively (p < 0.001). Multivariate analyses also showed that UACR >102.6 mg/g (OR: 1.76; 95% CI, 0.99–3.16; p = 0.011) was independently associated with in-hospital mortality, while a low eGFR was not associated. Conclusion: Microalbuminuria at admission may allow rapid prediction of prognosis in patients with APE. © 2020