#3693 Urinary albumin-to-creatinine ratio as a biomarker for predicting coronary artery disease severity

Abstract Background and Aims Cardiovascular diseases, particularly coronary artery disease (CAD), represent a leading global health burden. Among the markers associated with CAD, the urinary albumin-to-creatinine ratio (UACR) has garnered attention for its predictive value. Albuminuria, reflecting endothelial dysfunction and microvascular damage, has been implicated as a strong independent risk factor for cardiovascular morbidity and mortality. This study investigates the correlation between UACR levels and the presence and severity of CAD. Method A cross-sectional study was conducted over six months (January 2024–June 2024) at two tertiary care centers. A total of 150 patients admitted for suspected or confirmed CAD were enrolled. UACR was measured using early-morning urine samples and classified into categories: normal (<30 mg/g), microalbuminuria (30–300 mg/g), and macroalbuminuria (>300 mg/g). Coronary angiography determined the severity of CAD using Syntax Scores. Statistical analyses included correlation, regression, and subgroup analyses. Results Among the 150 participants (65% male, mean age 66.4 years), elevated UACR levels were strongly associated with higher Syntax Scores, indicating more severe CAD. Patients with UACR levels >30 mg/g were significantly more likely to present with multivessel disease, with 68% of those exhibiting macroalbuminuria having severe CAD (Syntax Score >27) Figs 1 and 2. A positive correlation was observed between UACR and the number of affected coronary vessels (Pearson's r = 0.621, P < 0.01). Additionally, elevated UACR levels were linked to markers of systemic inflammation (e.g., CRP) and metabolic disorders such as diabetes and hypertension, further underscoring its role as a comprehensive cardiovascular risk marker. Conclusion UACR serves as a robust predictor of CAD severity and a potential biomarker for identifying high-risk patients. Its utility extends beyond kidney function assessment, providing critical insights into cardiovascular health. Incorporating UACR into routine clinical evaluations may enhance risk stratification and guide therapeutic interventions in CAD management.