A simple and inexpensive test can help detect the risk of cardiovascular events in patients with diabetes.

The presentation at the recent American Heart Association Scientific Sessions in Chicago noted that albuminuria is known as a significant predictor for cardiovascular events in diabetic patients. In this study, Japanese researchers sought to also evaluate the effect of proteinuria on the incidence rate of cardiovascular events in diabetic patients. 

Red blood cells. Source

Data came from the Japanese primary prevention of atherosclerosis with aspirin for diabetes (JPAD) trial, which was performed to examine the efficacy of low-dose aspirin therapy for the primary prevention of atherosclerotic events in type 2 diabetic patients from 2002 to 2008.

After completion of the JPAD trial, the study team followed-up with the patients until 2015. Of the 2,536 JPAD patients, 42 patients were excluded because of a lack of proteinuria data on registration.

The new study compared the incidence rates of cardiovascular events between 446  proteinuria positive patients vs. 2,048 proteinuria negative patients. A urine dipstick test was used to determine proteinuria status.

Results indicated that, during a median of 10.3 years follow-up, 332 patients experienced a first cardiovascular event. Of those, 136 patients had a stroke and 54 patients suffered acute myocardial infarction.

Researchers explained that the incidence rate of cardiovascular events was significantly higher in proteinuria positive patients than in proteinuria negative patients, for a hazard ratio of 1.75 (1.36-2.23). The incidence rate of stroke was also significantly higher in proteinuria positive patients than in proteinuria negative patients, with an HR of 1.76 (1.14-2.49).

Using a Cox Proportional Hazards model, the study team listed the following predictors for cardiovascular events:

• Proteinuria positive 1.66 (1.26-2.15);

• Age 65 or older, 1.97 (1.54-2.53);

• Male sex, 1.50 (1.18-1.90);

• BMI 24 kg/m2 or greater, 0.98 (0.77-1.24);

• Duration of diabetes of 7 years or greater 1.31 (1.03-1.67);

• Use of Angiotensin Converting Enzyme Inhibitor or Angiotensin II Type 1 Receptor Blocker 1.15 (0.90-1.46);

• Hemoglobin A1c of 7.2% or greater 1.51 (1.19-1.91); and

• Use of Aspirin 0.93 (0.74-1.17).

“Our study demonstrates that proteinuria is independently associated with the incidence of cardiovascular events in diabetic patients with no history of atherosclerotic events,” study authors wrote. “Proteinuria, which is simple and inexpensive to test, is useful as a simple tool for risk assessment of diabetic patients.”