P11 Creatinine level and albuminuria and their association with cardiovascular events un type 2 diabetics patients

Abstract

Introduction: The cardiovascular disease and the kidney disease constitute the main cause of mortality in type 2 diabetics patients so it matters to know the relative value of the creatinine level and the presence of albuminuria in the prediction of cardiovascular events (CVE) in these patients.

Objectives: to know the strength of association between creatinine levels and the presence of albuminuria with the presence of cardiovascular events (CVE) in type 2 diabetics patients,comparing the relative value of both determination in their prediction.

Materials and methods: In 270 type 2 diabetic patients,age X 66±10,2years,masc 138/fem132,we analyzed the average of the last three determinations of creatinine (modified Jaffe method)and the quotient albuminuria/creatininuria by nephelmometry in the first urine sample.In those patients were registered main cardiovascular events (CVE): Atherosclerotic cardiovascular disease (ASCV): myocardial infarction,angina pectoris,angioplasty , myocardial revascularización surgery or of the lower limbs. Non atherosclerotic cardiovascular events (NASCV):heart failure and arrhythmias STATISTICAL ANALYSIS : Chi 2 ( Yates), ANOVA one way, parametric and non parametric correlation, ROC curve, logistic regresión univariate and multiple.

Results: 31,5% of the patients had some CVE.In the univariate análysis was registered a significant association between the creatinine values and CVE in the ROC curve, with a cutoff value of 1,42 mg/dl (AUC:0,595)((p<0,001).A cutoff value of albuminuria/creatininuria more than 88 mg/g was associated with more numbers of CVE although the ROC curve was not significant (AUC:0,507, p:0,07). In the multivariate análysis by logistic regresión,adjusting other variables (BMI,smoke habit, systolic and diastolic blood pressure, total cholesterol, HDL and tryglicerides), the creatinine level, age and cholesterol HDL levels were significantly associated with CVE (178% increased risk for creatinine levels equal or over 1,42 mg/dl) while the albuminuric levels were non significantly associated with CVE (OR:1,49:p:0,298).

Conclusions: In the univariate análysis both variables (creatinine and albuminuria) were associated with more number of CVE events. However, in the multivariate análisis, only the creatinine level remained significantly associated with CVE.