Abstract Details

Title Association between albuminuria and the risk of stroke: a secondary analysis of the SPRINT trial

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-008

Objective We aimed to evaluate the association of albuminuria with the risk of stroke among non-diabetic patients.

Background Albuminuria, a systemic endothelial dysfunction marker, is a stroke risk factor. While this has been shown in patients with diabetes, there are few studies in patients without diabetes. In The Systolic Blood Pressure Intervention Trial (SPRINT), which included patients without diabetes or prior stroke, intensive blood pressure (BP) treatment resulted in lower rates of the primary composite cardiovascular outcome. However, there was no significant difference in the risk of stroke.

Design/Methods We performed a secondary analysis of the SPRINT trial including 8,913 participants categorized according to the presence of baseline albuminuria (urinary albumin-to-creatinine ratio ≥30 mg/g). Unadjusted and adjusted Cox proportional-hazards models were fit to estimate the association of albuminuria with stroke risk. We also assessed the interaction of intensive BP treatment with albuminuria regarding stroke risk.

Results Mean age was 68±9 years, 35% were female, and 32% were black. Median follow-up was 3.2 years and 19% of patients had baseline albuminuria. There were 129 strokes. Albuminuria was associated with increased stroke risk (unadjusted hazard ratio [HR] 2.24; 95% CI 1.55-3.23, p<0.001; adjusted HR 1.74; 95% CI 1.18-2.57, p=0.006). The effect of intensive BP treatment differed according to albuminuria groups (P-interaction=0.03). Whereas intensive BP treatment (versus standard) was not associated with a reduction in the risk of stroke among participants with albuminuria (HR 1.13; 95% CI 0.73-1.74, p=0.59), it was associated with a reduction in stroke risk among those with albuminuria (HR 0.45; 95% CI 0.24-0.85, p=0.01).

Conclusions In a post-hoc analysis of the SPRINT, baseline albuminuria was associated with a higher stroke risk in the overall cohort, with evidence of effect modification according to the randomized treatment arm. Further studies are required to investigate the potential mechanisms underlying this observation.

Authors/Disclosures
Ricardo J. Soares Dos Reis, MD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

��ɫ��

��ɫ��