Microalbuminuria as a potential novel cardiovascular biomarker in patients with COPD

Chronic obstructive pulmonary disease (COPD) is now recognised as the third cause of death in the world [1]. Patients with COPD are more likely to have pre-existing cardiovascular disease (CVD) and are at high risk of acute events, hospitalisations and death from CVD [2, 3]. Furthermore, this strong association is independent of the degree of airflow limitation. Because of this, the Global Initiative for Chronic Obstructive Lung Disease initiative recognises CVD as the most important disease coexisting with COPD and suggests it should be routinely looked for, but makes no recommendation on how to do it [4]. Over the past two decades, interest in CVD prevention has expanded and now promotes not only primary prevention, but also identification of factors that could help clarify CVD pathophysiology, offer targets for intervention or lead to improved risk stratification beyond that allowed by the Framingham equations [5]. Currently, only a few biomarkers have been accepted as being clinically useful [6]. In this regard, the recent consensus of the American College of Cardiology/American Heart Association recognises family history as being useful and haemoglobin A1c measurement as reasonable in all adults. They also categorise microalbuminuria (MAB) assessment as reasonable in adults with hypertension or diabetes [7]. The discovery of novel “biomarkers” that could help identify cardiovascular risk in patients with COPD could help personalise therapy for that particular phenotype. To be clinically useful, the biomarker should be inexpensive, noninvasive and easily measurable. Therefore, MAB could be a …

[1]  P. Romundstad,et al.  COPD and microalbuminuria: a 12-year follow-up study , 2014, European Respiratory Journal.

[2]  C. Delles,et al.  Proteinuria and its relation to cardiovascular disease , 2013, International journal of nephrology and renovascular disease.

[3]  A. Folsom,et al.  Classical and Novel Biomarkers for Cardiovascular Risk Prediction in the United States , 2013, Journal of epidemiology.

[4]  Bernadette A. Thomas,et al.  Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[5]  U. Kisa,et al.  Microalbuminuria in Chronic Obstructive Pulmonary Disease , 2012, COPD.

[6]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[7]  S. Sharma,et al.  Cardiovascular and renal effects of chronic exposure to high altitude. , 2012, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[8]  Zahi A Fayad,et al.  2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. , 2010, Circulation.

[9]  M. Budoff,et al.  2010 ACCF/AHA Guideline for Assessment of Cardiovascular Risk in Asymptomatic Adults: Executive Summary , 2010 .

[10]  B. Celli,et al.  Microalbuminuria and hypoxemia in patients with chronic obstructive pulmonary disease. , 2010, American journal of respiratory and critical care medicine.

[11]  S. Yusuf,et al.  Telmisartan, ramipril, or both in patients at high risk for vascular events. , 2008, The New England journal of medicine.

[12]  Ç. Yenisey,et al.  Microalbuminuria, von Willebrand factor and fibrinogen levels as markers of the severity in COPD exacerbation , 2008, Journal of Thrombosis and Thrombolysis.

[13]  Bartolome Celli,et al.  Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. , 2007, The New England journal of medicine.

[14]  P. Palatini,et al.  Glomerular hyperfiltration predicts the development of microalbuminuria in stage 1 hypertension: the HARVEST. , 2006, Kidney international.

[15]  P. Hildebrandt,et al.  N-terminal pro-brain natriuretic peptide, C-reactive protein, and urinary albumin levels as predictors of mortality and cardiovascular events in older adults. , 2005, JAMA.

[16]  A. Iskandrian,et al.  Brachial artery reactivity in asymptomatic patients with type 2 diabetes mellitus and microalbuminuria (from the Detection of Ischemia in Asymptomatic Diabetics-brachial artery reactivity study). , 2004, The American journal of cardiology.

[17]  G. Cerasola,et al.  Relationship between albumin excretion rate and aortic stiffness in untreated essential hypertensive patients , 2004, Journal of internal medicine.

[18]  K. Kohara,et al.  Microalbuminuria and arterial stiffness in a general population: the Shimanami Health Promoting Program (J-SHIPP) study. , 2004, Hypertension research : official journal of the Japanese Society of Hypertension.

[19]  G. Tibet,et al.  Microalbuminuria in chronic obstructive pulmonary disease. , 2003, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[20]  S. Romundstad,et al.  Microalbuminuria and all-cause mortality in 2,089 apparently healthy individuals: a 4.4-year follow-up study. The Nord-Trøndelag Health Study (HUNT), Norway. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[21]  A. Cogo,et al.  Proteinuria in COPD patients with and without respiratory failure. , 2003, Chest.

[22]  Alan D. Lopez,et al.  The Global Burden of Disease Study , 2003 .

[23]  S. Antoniu,et al.  Hospitalizations and mortality in the Lung Health Study , 2002, Expert review of pharmacoeconomics & outcomes research.

[24]  R. Pauwels,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. , 2001, American journal of respiratory and critical care medicine.

[25]  D. Levy,et al.  Prediction of coronary heart disease using risk factor categories. , 1998, Circulation.