Association between urinary albumin excretion and coronary heart disease in black vs white adults.
Association between urinary albumin excretion and coronary heart disease in black vs white adults.
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DOI：
10.1001/jama.2013.8777
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发表时间：
2013-08-21
影响因子：
120.7
通讯作者：
Safford, Monika M.
中科院分区：
文献类型：
--
作者：
Gutierrez, Orlando M.;Khodneva, Yulia A.;Muntner, Paul;Rizk, Dana V.;McClellan, William M.;Cushman, Mary;Warnock, David G.;Safford, Monika M.
尿白蛋白排泄过多在黑人个体中比在白色个体中更常见，并且与黑人中的中风风险比白人中的中风风险更强相关。类似的关联是否延伸到冠心病（CHD）尚不清楚。确定尿白蛋白排泄与CHD事件的相关性是否因种族而异。在卒中的地理和种族差异原因（REGARDS）研究中，一项前瞻性队列研究，在2003年至2007年期间招募了年龄≥45岁的黑人和白色美国成年人，随访至2009年12月31日，我们检查了尿白蛋白/肌酐比（ACR）与（1）基线时无CHD的23，273名参与者中CHD事件的种族分层相关性，（2）4，934例基线时患有CHD的受试者中首次复发CHD事件。专家裁定的事件和复发性心肌梗死（MI）和急性CHD死亡。在平均4.4年的随访中，共观察到616例CHD事件（421例非致死性MI和195例CHD死亡）和468例CHD复发事件（279例非致死性MI和189例CHD死亡）。在基线时无CHD的患者中，每1000人-年随访的年龄和性别校正CHD发病率随着ACR类别的增加而增加，在黑人和白人中，ACR最高类别的发病率高出近1.5倍。（>300 mg/g）（黑人20.59，95%置信区间[14.36，29.51] vs白人13.60 [7.60，24.25]）。在校正了传统心血管危险因素和药物的比例风险模型中，黑人中较高的基线尿ACR与较高的冠心病发病风险相关（ACR >300与<10 mg/g的风险比[HR]为3.21 [2.02，5.09]），但白人无（HR比较ACR >300与<10 mg/g，1.49 [0.80，2.76]）（P-相互作用=0.03）。在基线时患有CHD的患者中，完全校正的基线尿ACR与首次复发CHD事件的相关性在黑人和白人中相似（ACR >300 vs. <10 mg/g的HR，黑人2.21 [1.22，4.00] vs.白人2.48 [1.61，3.78]）（P-相互作用=0.53）。与白人相比，黑人中较高的尿ACR与较高的CHD事件风险相关，但与CHD复发风险无关。
Excess urinary albumin excretion is more common in black individuals than in white individuals and is more strongly associated with incident stroke risk in blacks than whites. Whether similar associations extend to coronary heart disease (CHD) is unclear. To determine whether the association of urinary albumin excretion with CHD events differs by race. Within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a prospective cohort of black and white US adults ≥45 years of age enrolled between 2003 and 2007 with follow-up through December 31 2009, we examined race-stratified associations of urinary albumin to creatinine ratio (ACR) with (1) incident CHD among 23,273 participants free of CHD at baseline, and (2) first recurrent CHD event among 4,934 participants with CHD at baseline. Expert-adjudicated incident and recurrent myocardial infarction (MI) and acute CHD death. A total of 616 incident CHD events (421 non-fatal MIs and 195 CHD deaths) and 468 recurrent CHD events (279 non-fatal MIs and 189 CHD deaths) were observed over a mean 4.4 years of follow-up. Among those free of CHD at baseline, age- and sex-adjusted incidence rates of CHD per 1000 person-years of follow-up increased with increasing categories of ACR in blacks and whites, with rates being nearly 1.5-fold higher in the highest category of ACR (>300 mg/g) in blacks vs. whites (20.59, 95% confidence interval [14.36,29.51] in blacks vs. 13.60 [7.60,24.25] in whites). In proportional hazards models adjusted for traditional cardiovascular risk factors and medications, higher baseline urinary ACR was associated with higher risk of incident CHD among blacks (hazard ratio [HR] comparing ACR >300 vs. <10 mg/g, 3.21 [2.02,5.09]) but not whites (HR comparing ACR >300 vs. <10 mg/g, 1.49 [0.80,2.76]) (P-interaction=0.03). Among those with CHD at baseline, fully-adjusted associations of baseline urinary ACR with first recurrent CHD event were similar in blacks and whites (HR comparing ACR >300 vs. <10 mg/g, 2.21 [1.22,4.00] in blacks vs. 2.48 [1.61,3.78] in whites) (P-interaction=0.53). Higher urinary ACR was associated with higher risk of incident but not recurrent CHD in blacks compared to whites.
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影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
13.6
作者：
Peralta, Carmen A.;Shlipak, Michael G.;Go, Alan S.
通讯作者：
Go, Alan S.
DOI：
10.1053/j.ajkd.2012.03.011
发表时间：
2012-08
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Waheed S;Matsushita K;Sang Y;Hoogeveen R;Ballantyne C;Coresh J;Astor BC
通讯作者：
Astor BC
影响因子：
5.4
作者：
Silva, A. M. V.;Schaan, B. D.;Irigoyen, M. C.
通讯作者：
Irigoyen, M. C.
DOI：
10.2215/cjn.04960512
发表时间：
2013-03-01
影响因子：
9.8
作者：
Waheed, Salman;Matsushita, Kunihiro;Coresh, Josef
通讯作者：
Coresh, Josef