ArticleBMJ open2021
Urinary albumin-to-creatinine ratio levels are associated with subclinical atherosclerosis and predict CVD events and all-cause deaths: a prospective analysis.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 27 citations in OpenAlex.
- Increased 24-h blood pressure and arterial stiffness in young adults with childhood-onset type 1 diabetes: the Norwegian Atherosclerosis and Childhood Diabetes study.Journal of hypertension · 2026Article
- Potential of R Wave in aVL Lead in Cardiovascular Risk Assessment.Biomedicines · 2026Article
- Very low-grade albuminuria is linked to arterial stiffness in a population-based cohort.American journal of preventive cardiology · 2026Article
- Chronic kidney disease screening to reduce cardiovascular risk: a call to action.American journal of preventive cardiology · 2026Article
- Development and external validation of a machine learning model for predicting in-hospital mortality in ICU patients with diabetic kidney disease: a study utilizing the MIMIC database and a Chinese cohort.Frontiers in endocrinology · 2026Article
- Sex differences in the prognostic value of urinary albumin-to-creatinine ratio for coronary artery disease and cardiovascular events in people with type 2 diabetes and normoalbuminuria.Cardiovascular diabetology · 2025Article
- Change in urine albumin-to-creatinine ratio and clinical outcomes in patients with chronic kidney disease and type 2 diabetes.BMJ open diabetes research & care · 2025Article
- Urinary albumin-to-creatinine ratio as an independent predictor of long-term mortality in atherosclerotic cardiovascular disease patients: A propensity score-matched study: UACR and Long-term Mortality in ASCVD.American journal of preventive cardiology · 2025Article
- Association between serum creatinine-to-albumin ratio and 28-day mortality in intensive care unit patients following cardiac surgery: analysis of mimic-iv data.BMC cardiovascular disorders · 2025Article
- Pathophysiology and emerging biomarkers of cardiovascular-renal-hepato-metabolic syndrome.Frontiers in cardiovascular medicine · 2025Review
- The Relationship between Job Strain and Ischemic Heart Disease Mediated by Endothelial Dysfunction Markers and Imaging.Medicina (Kaunas, Lithuania) · 2024Article
- Association of Urine Albumin to Creatinine Ratio With Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus.The Journal of clinical endocrinology and metabolism · 2024Article
- Photodynamic Therapy for Atherosclerosis.International journal of molecular sciences · 2024Review
- Relationship Between Lipoprotein(a), Renal Function Indicators, and Chronic Kidney Disease: Evidence From a Large Prospective Cohort Study.JMIR public health and surveillance · 2024Article
- Relationship Between Hypertension and Hearing Loss: Analysis of the Related Factors.Clinical interventions in aging · 2024Observational
- Effect of Urinary Albumin Creatinine Ratio on Cardiovascular Morbidity and Mortality in Diabetes Patients with Atherosclerotic Disease.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
- Association of serum creatinine with hepatic steatosis and fibrosis: a cross-sectional study.BMC gastroenterology · 2022Article
- Prevalence of Microalbuminuria and Its Association with Subclinical Carotid Atherosclerosis in Middle Aged, Nondiabetic, Low to Moderate Cardiovascular Risk Individuals with or without Hypertension.Diagnostics (Basel, Switzerland) · 2021Article
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Authors and funding
19 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe aimed to examine the associations of urinary albumin-to-creatinine ratio (ACR) levels with risks of subclinical atherosclerosis, cardiovascular events and all-cause deaths.
methodsData from a large population-based cohort were used, which included 9580 participants aged ≥40 years free from cardiovascular diseases. Carotid intima-media thickness, brachial-ankle pulse wave velocity and ankle-brachial index were measured at baseline to assess subclinical atherosclerosis. After a median of 4.53 years' follow-up, 486 cardiovascular events and 230 all-cause deaths were recorded.
resultsThe urinary ACR levels were categorised into three groups. Compared with the normal group (0≤ACR <7.82 mg/g), people with low-grade albuminuria (7.82≤ACR <30 mg/g) and albuminuria (ACR ≥30 mg/g) had higher levels of subclinical atherosclerosis. In prospective analysis, people with low-grade albuminuria was not significantly associated with cardiovascular events (HR=1.18; 95% CI 0.95 to 1.46], whereas people with albuminuria had a 50% higher risk of cardiovascular events (HR=1.50; 95% CI 1.11 to 2.03). People with low-grade albuminuria and albuminuria had 43% (HR=1.43; 95% CI 1.05 to 1.93) and 87% (HR=1.87; 95% CI 1.24 to 2.81) higher risks of all-cause deaths during follow-up, respectively. In stratified analysis, the association of higher ACR with risks of cardiovascular events and all-cause deaths was stronger among individuals with concomitant subclinical atherosclerosis, the presence of diabetes and more cardiovascular risk factors, respectively.
conclusionsACR levels were positively associated with subclinical atherosclerosis and predicted the risks of cardiovascular events and all-cause deaths. Evaluation of ACR levels should be integrated into risk stratification and prevention of cardiovascular events and all-cause deaths, especially among those with pre-existing subclinical atherosclerosis and cardiometabolic abnormalities.
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