{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:34:58Z","timestamp":1790634898629,"version":"4.1.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,4,16]]},"abstract":"\n Background<\/jats:title>\n \n In patients with myocardial infarction (\n MI<\/jats:styled-content>\n ), reduced kidney function is recognized as an important predictor of poor prognosis, but the impact of albuminuria, a representative measure of kidney damage, has not been extensively evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In the\n SCREAM<\/jats:styled-content>\n (Stockholm Creatinine Measurements) project (2006\u20132012), we identified 2469 patients with incident\n MI<\/jats:styled-content>\n with dipstick proteinuria measured within a year before\n MI<\/jats:styled-content>\n (427 patients also had urine albumin to creatinine ratio [\n ACR<\/jats:styled-content>\n ] measured concurrently) and obtained estimates for\n ACR<\/jats:styled-content>\n with multiple imputation in participants with data solely on dipstick proteinuria. We quantified the association of\n ACR<\/jats:styled-content>\n with the post\u2010\n MI<\/jats:styled-content>\n composite and individual outcomes of all\u2010cause mortality, cardiovascular mortality, recurrent\n MI<\/jats:styled-content>\n , ischemic stroke, or heart failure using Cox models and then evaluated the improvement in\n C<\/jats:italic>\n statistic. During a median follow\u2010up of 1.0\u00a0year after\n MI<\/jats:styled-content>\n , 1607 participants (65.1%) developed the post\u2010\n MI<\/jats:styled-content>\n composite outcome. Higher\n ACR<\/jats:styled-content>\n levels were independently associated with all outcomes except for ischemic stroke. Per 8\u2010fold higher\n ACR<\/jats:styled-content>\n (eg, 40 versus 5\u00a0mg\/g), the hazard ratio of composite outcome was 1.21 (95%\n CI<\/jats:styled-content>\n , 1.08\u20131.35). The addition of the\n ACR<\/jats:styled-content>\n improved the\n C<\/jats:italic>\n statistic of the post\u2010\n MI<\/jats:styled-content>\n composite by 0.040 (95% CI, 0.030\u20130.051). Largely similar results were obtained regardless of diabetic status and when\n ACR<\/jats:styled-content>\n or dipstick was separately analyzed without imputation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In patients with\n MI<\/jats:styled-content>\n , albuminuria was a potent predictor of subsequent outcomes, suggesting the importance of paying attention to the information on albuminuria, in addition to kidney function, in this high\u2010risk population.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.010546","type":"journal-article","created":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T09:00:32Z","timestamp":1554454832000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Albuminuria as a Predictor of Cardiovascular Outcomes in Patients With Acute Myocardial 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