Increased urinary IgM excretion in patients with chest pain due to coronary artery disease
Tofik, Rafid LU ; Ekelund, Ulf LU
; Torffvit, Ole
LU
; Swärd, Per
LU
; Rippe, Bengt
LU
and Bakoush, Omran
LU
(2013)
In BMC Cardiovascular Disorders
13.
- Abstract
- Background: Micro-albuminuria is a recognized predictor of cardiovascular morbidity and mortality in patients with coronary artery disease. We have previously reported, in diabetic and non-diabetic patients, that an increased urinary excretion of IgM is associated with higher cardiovascular mortality. The purpose of this study was to investigate the pattern of urinary IgM excretion in patients with acute coronary syndrome (ACS) and its correlation to cardiovascular outcome. Methods: Urine albumin, and IgM to creatinine concentration ratios were determined in 178 consecutive patients presenting with chest pain to the Department of Emergency Medicine (ED) at the University Hospital of Lund. Fifty eight (23 female) patients had ACS, 55 (19... (More)
- Background: Micro-albuminuria is a recognized predictor of cardiovascular morbidity and mortality in patients with coronary artery disease. We have previously reported, in diabetic and non-diabetic patients, that an increased urinary excretion of IgM is associated with higher cardiovascular mortality. The purpose of this study was to investigate the pattern of urinary IgM excretion in patients with acute coronary syndrome (ACS) and its correlation to cardiovascular outcome. Methods: Urine albumin, and IgM to creatinine concentration ratios were determined in 178 consecutive patients presenting with chest pain to the Department of Emergency Medicine (ED) at the University Hospital of Lund. Fifty eight (23 female) patients had ACS, 55 (19 female) patients had stable angina (SA), and 65 (35 female) patients were diagnosed as non-specific chest pain (NS). Results: Urine albumin and IgM excretions were significantly higher in patients with ACS (p = 0.001, and p = 0.029, respectively) compared to patients with NS-chest pain. During the 2 years follow-up time, 40 (19 female) patients suffered a new major cardiovascular event (ACS, acute heart failure, stroke) and 5 (4 male/1 female) patients died of cardiovascular cause. A high degree of albuminuria and IgM-uria significantly predicted cardiovascular mortality and morbidity (HR = 2.89, 95% CI: 1.48 - 5.66, p = 0.002). Microalbuminuric patients (>= 3 mg/mmol) with high IgM-uria (>= 0.005 mg/mmol) had a 3-fold higher risk for cardiovascular new events compared to patients with low IgM-uria (RR = 3.3, 95% CI: 1.1 - 9.9, p = 0.001). Conclusion: In patients with chest pain, an increased urine IgM excretion, is associated with coronary artery disease and long-term cardiovascular complications. Measuring urine IgM concentration could have a clinical value in risk stratification of patients with ACS. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4098945
- author
- Tofik, Rafid
LU
; Ekelund, Ulf
LU
; Torffvit, Ole
LU
; Swärd, Per
LU
; Rippe, Bengt
LU
and Bakoush, Omran
LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Urine IgM, Microalbuminuria, Acute coronary syndrome, Chest pain, Cardiovascular mortality
- in
- BMC Cardiovascular Disorders
- volume
- 13
- article number
- 72
- publisher
- BioMed Central (BMC)
- external identifiers
-
- wos:000324868500001
- scopus:84883707725
- pmid:24028208
- ISSN
- 1471-2261
- DOI
- 10.1186/1471-2261-13-72
- language
- English
- LU publication?
- yes
- id
- 82d69a9e-fd56-4e06-a7f2-a1f36eba6963 (old id 4098945)
- date added to LUP
- 2016-04-01 13:32:45
- date last changed
- 2024-01-24 11:55:52
@article{82d69a9e-fd56-4e06-a7f2-a1f36eba6963,
abstract = {{Background: Micro-albuminuria is a recognized predictor of cardiovascular morbidity and mortality in patients with coronary artery disease. We have previously reported, in diabetic and non-diabetic patients, that an increased urinary excretion of IgM is associated with higher cardiovascular mortality. The purpose of this study was to investigate the pattern of urinary IgM excretion in patients with acute coronary syndrome (ACS) and its correlation to cardiovascular outcome. Methods: Urine albumin, and IgM to creatinine concentration ratios were determined in 178 consecutive patients presenting with chest pain to the Department of Emergency Medicine (ED) at the University Hospital of Lund. Fifty eight (23 female) patients had ACS, 55 (19 female) patients had stable angina (SA), and 65 (35 female) patients were diagnosed as non-specific chest pain (NS). Results: Urine albumin and IgM excretions were significantly higher in patients with ACS (p = 0.001, and p = 0.029, respectively) compared to patients with NS-chest pain. During the 2 years follow-up time, 40 (19 female) patients suffered a new major cardiovascular event (ACS, acute heart failure, stroke) and 5 (4 male/1 female) patients died of cardiovascular cause. A high degree of albuminuria and IgM-uria significantly predicted cardiovascular mortality and morbidity (HR = 2.89, 95% CI: 1.48 - 5.66, p = 0.002). Microalbuminuric patients (>= 3 mg/mmol) with high IgM-uria (>= 0.005 mg/mmol) had a 3-fold higher risk for cardiovascular new events compared to patients with low IgM-uria (RR = 3.3, 95% CI: 1.1 - 9.9, p = 0.001). Conclusion: In patients with chest pain, an increased urine IgM excretion, is associated with coronary artery disease and long-term cardiovascular complications. Measuring urine IgM concentration could have a clinical value in risk stratification of patients with ACS.}},
author = {{Tofik, Rafid and Ekelund, Ulf and Torffvit, Ole and Swärd, Per and Rippe, Bengt and Bakoush, Omran}},
issn = {{1471-2261}},
keywords = {{Urine IgM; Microalbuminuria; Acute coronary syndrome; Chest pain; Cardiovascular mortality}},
language = {{eng}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Cardiovascular Disorders}},
title = {{Increased urinary IgM excretion in patients with chest pain due to coronary artery disease}},
url = {{https://lup.lub.lu.se/search/files/3439759/4254928}},
doi = {{10.1186/1471-2261-13-72}},
volume = {{13}},
year = {{2013}},
}