Elevated urine albumin-to-creatinine ratio increases the risk of new-onset heart failure in patients with type 2 diabetes
Authors' conclusion
Increasing uACR, even below the normal range, is an independent risk factor for new-onset HF in a type 2 diabetic population. Furthermore, uACR may improve HF risk prediction in community-based T2D patients.
Study context
- Population
- Chinese adults with T2D and no heart failure (HF), assessed with urine albumin-to-creatinine ratio (uACR) between 2014 and 2016
- Participants
- 9,287 adults
- Exposure
- Microalbuminuria and macroalbuminuria vs normal uACR
- Outcome
- New-onset HF
- Follow-up
- Median 4.05 years
Methodological detailscommunity-based
- Community-based
Main finding
As reported in the abstract
Each group vs normalAdjusted hazard ratio (95% CI)
Microalbuminuria
2.21(1.59–3.06)
Macroalbuminuria
6.02(4.11–8.80)
- New-onset HF cases, overall
- 216 (2.33%)
- aHR per 1 SD in ln(uACR)
- 1.89 (95% CI 1.68-2.13)
Observational data: associations, not effects.
Further findings
Subgroups (sex, eGFR, systolic blood pressure, HbA1c)
- Results consistent across sex, eGFR, systolic blood pressure and HbA1c subgroups
HF risk prediction
- Adding uACR to established HF risk models improved HF risk prediction efficacy
Original publication
Elevated urine albumin-to-creatinine ratio increases the risk of new-onset heart failure in patients with type 2 diabetes. Cardiovasc Diabetol. Published 25 March 2023. doi:10.
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