CORRELATION OF MICROALBUMINURIA ON THE SEVERITY OF CORONARY ARTERY DISEASE AMONG DIABETIC PATIENTS

Abstract

Background: Cardiovascular disease is the primary cause of illness and death in those with diabetes mellitus. Microalbuminuria has emerged as a prominent and early predictor of endothelial dysfunction and systemic vascular injury among the numerous markers used to predict cardiovascular risk in this population. Aim: To assess the correlation between microalbuminuria and the severity of coronary artery disease in patients with type 2 diabetes mellitus. Methods: This observational, cross-sectional study was carried out over five months, from March 2025 to July 2025, in the cardiology department at Government Sivagangai Medical College, Tamilnadu, India. A total of 125 individuals with type 2 diabetes mellitus, who had coronary angiography to assess suspected or confirmed ischemic heart disease, were included. Individuals with established chronic kidney disease (CKD stage 3 or above), urinary tract infections, or significant proteinuria were excluded. Microalbuminuria was evaluated by the spot urine albumin-to-creatinine ratio (ACR), and individuals were divided into two groups: Group A - Normoalbuminuria (ACR < 30 mg/g) and Group B - Microalbuminuria (ACR 30–300 mg/g) The severity of coronary artery disease (CAD) was assessed using coronary angiographic findings and quantified with the SYNTAX score. Information on demographics, diabetes duration, HbA1c levels, blood pressure, lipid profile, and body mass index (BMI) were documented and examined. Results: Among the 125 patients, 73 (58.4%) exhibited microalbuminuria. The average SYNTAX score in individuals with microalbuminuria was markedly elevated in comparison to those with normoalbuminuria (23.1 ± 7.4 vs. 14.6 ± 5.8, p < 0.001). A positive connection (r = 0.61, p < 0.01) was identified between urine ACR and SYNTAX scores. Additionally, patients in Group B exhibited a prolonged duration of diabetes, elevated HbA1c levels, and increased average systolic blood pressure. Conclusion: Microalbuminuria is markedly correlated with heightened severity of CAD in individuals with type 2 diabetes mellitus. Microalbuminuria, being a non-invasive and readily accessible biomarker, can function as an early signal for cardiovascular risk assessment in diabetes patients. Timely identification and intervention may mitigate cardiovascular morbidity in this high-risk demographic.