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8 - Microalbuminuria in acute myocardial infarction and efficacy of thrombolytic treatment on microalbuminuria levels
İbrahim Erbay, Mahmut Gümüş, Haluk Sargın, Serdar Fenercioğlu, Mehmet Sargın, Mesut Şeker, Atilla Yavuz, Ali Yayla
Objectives: It is important to define rise factors for both primary and secondary prevention of coronary heart disease. An increase on microalbuminuria during acute myocardial infarction is known but mechanism of this isnt determined. In our study, we studied variation in microalbuminuria levels and efficacy of thrombolytic treatment on it during acute myocardial infarction.
Study design: 40 patients who were put on thrombolytic treatment because of acute myocardial infarction and other 40 patients who were also diagnosed as acute myocardial infarction but were not thought to have an indication for thrombolytic treatment, were included into the study. Blood samples for biochemical parameters were obtained in the first hour and 7th day after hospitalization of the patients. Also, total urine in the first 24 hours were collected after obtaining a spot urine. Quantitative microalbuminuria measurements was made in 24 hours urine samples.
Results: Albuminuria levels were 423.21 ±276. 3 mg!day in 24 hours urine of the first day and 238.78±154.2 mg/day of 7th day. There was a statistically significant difference between albuminuria levels of the first and 7th day urine samples (p<0. 0001).
Also, there was a statistically significant difference between patients who were put on thrombolytic treatment and not, according to 24 hours urine albuminuria levels of the first day (p<0.00l). But there was no statistically significant difference between these groups according to albuminuria levels of 7th day (p<0.05).
Conclusions: The presence of an increase in urinary protein extraction rate is supporting hypothesis which suggets that an increase in systemic vascular permeability is caused by ischemia. It is thougt that increase of proteinuria is depending on hemodynamic changes like activation in reninangiotensin system, damage on vascular endotelial wall and increase of vascular permeability.
Keywords: Microalbuminuria, acute myocardial infarction, thrombolytic treatment
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