{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T10:22:09Z","timestamp":1768818129442,"version":"3.49.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,10,16]]},"abstract":"\n Background<\/jats:title>\n \n Chronic kidney disease is a recognized independent risk factor for cardiovascular disease, but whether the risks of ST\u2010segment\u2013elevation myocardial infarction (\n STEMI<\/jats:styled-content>\n ) and non\u2013ST\u2010segment\u2013elevation myocardial infarction (\n NSTEMI<\/jats:styled-content>\n ) differ in the chronic kidney disease population is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Using administrative data from Ontario, Canada, we examined patients \u226566\u00a0years of age with an outpatient estimated glomerular filtration rate (\n eGFR<\/jats:styled-content>\n ) and albuminuria measure for incident myocardial infarction from 2002 to 2015. Adjusted Fine and Gray subdistribution hazard models accounting for the competing risk of death were used. In 248\u00a0438 patients with 1.2\u00a0million person\u2010years of follow\u2010up,\n STEMI<\/jats:styled-content>\n ,\n NSTEMI<\/jats:styled-content>\n , and death occurred in 1436 (0.58%), 4431 (1.78%), and 30\u00a0015 (12.08%) patients, respectively. The highest level of albumin\u2010to\u2010creatinine ratio (>30\u00a0mg\/mmol) was associated with a 2\u2010fold higher adjusted risk of both\n STEMI<\/jats:styled-content>\n and\n NSTEMI<\/jats:styled-content>\n among patients with\n eGFR<\/jats:styled-content>\n \u226560\u00a0mL\/(min\u00b71.73\u00a0m\n 2<\/jats:sup>\n ) compared to albumin\u2010to\u2010creatinine ratio <3\u00a0mg\/mmol. The lowest level of\n eGFR<\/jats:styled-content>\n (<30\u00a0mL\/[min\u00b71.73\u00a0m\n 2<\/jats:sup>\n ]) was not associated with higher\n STEMI<\/jats:styled-content>\n risk but with a 4\u2010fold higher risk of\n NSTEMI<\/jats:styled-content>\n compared to those with\n eGFR<\/jats:styled-content>\n \u226560\u00a0mL\/(min\u00b71.73\u00a0m\n 2<\/jats:sup>\n ). The lowest\n eGFR<\/jats:styled-content>\n (<30\u00a0mL\/[min\u00b71.73\u00a0m\n 2<\/jats:sup>\n ]) and highest albumin\u2010to\u2010creatinine ratio (>30\u00a0mg\/mmol) were associated with a greater than 4\u2010fold higher risk of both\n STEMI<\/jats:styled-content>\n and\n NSTEMI<\/jats:styled-content>\n (subdistribution hazard models [95% confidence interval] 4.53 [3.30\u20106.21] and 4.42 [3.67\u20105.32], respectively) compared to albumin\u2010to\u2010creatinine ratio <3\u00a0mg\/mmol and\n eGFR<\/jats:styled-content>\n \u226560\u00a0mL\/(min\u00b71.73\u00a0m\n 2<\/jats:sup>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Elevations in albuminuria are associated with a higher risk of both\n NSTEMI<\/jats:styled-content>\n and\n STEMI<\/jats:styled-content>\n , regardless of kidney function, whereas reduced kidney function alone is associated with a higher\n NSTEMI<\/jats:styled-content>\n risk.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.009995","type":"journal-article","created":{"date-parts":[[2018,10,11]],"date-time":"2018-10-11T09:01:02Z","timestamp":1539248462000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Albuminuria, Reduced Kidney Function, and the Risk of ST\u2010 and non\u2013ST\u2010segment\u2013elevation myocardial infarction"],"prefix":"10.1161","volume":"7","author":[{"given":"Sonali N.","family":"de Chickera","sequence":"first","affiliation":[{"name":"Department of Medicine University of Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Bota","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Paul","family":"Kuwornu","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative 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