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Abstract MA indicates the excretion of albumin in the urine at a rate that exceeds normal limits, but which is below the detection level for standard urine dipstick methods. Results can be conveyed as milligrams per 24-h urine specimen, micrograms per minute in a timed urine specimen, or as micrograms per milligram creatinine in a random spot urine test. MA is currently defined as UAE rate of 30 to 300 mg when measured in a 24 h urine collection (simultaneous measurement of creatinine clearance), 20–200 μg/min, when assessed in a timed urine collection (either over 4 h, or overnight), or urinary albumin-to-creatinine ratio (UACR) of 30 to 300 mg/g in a spot urine collection. Urinary albumin levels below these limits are considered as normal UAE, whereas any value above them reflects the presence of macroalbuminuria or clinical proteinuria. Several studies have revealed various traditional and novel vascular risk factors that are associated with MA including increasing age, male sex, higher blood pressure, poor glycemic control, smoking, high sensitivity C-reactive protein, plasminogen activator inhibitor, ratio of plasminogen activator inhibitor to tissue-type plasminogen activator, insulin resistance, endothelial dysfunction, hyperhomo-cysteinemia, and high-fibrinogen levels. In fact, in some quarters, MA is regarded as an integrated cardiovascular risk marker. However, the exact pathophysiological mechanisms underlying the associations of these risk factors with MA are not well understood, and it is thought that the greater prevalence of these risk factors in persons with MA does not adequately explain the impact of elevated UAE on vascular risk MA is a frequent finding in several acute clinical conditions and UAE level appears to be directly proportional to the severity of many acute inflammatory processes including trauma, sepsis, surgery, muscle ischemia, and acute myocardial infarction. This study was designed to examine the possible role of microalbuminuria as an early marker and predictor of morbidity and mortality in cases with acute myocardial infraction. The results showed a good linkage between albumin/ creatinine ratio (indicator of microalbuminuria) and major adverse cardiovascular events and thus, it is recommended to add albumin/creatinine ratio as a routine test in investigation of acute myocardial infarction. |