Eur J Prev Cardiol. 2026 Mar 9:zwag137. doi: 10.1093/eurjpc/zwag137. Online ahead of print.
ABSTRACT
INTRODUCTION: Albuminuria is a significant marker for cardiovascular disease(CVD) in both diabetics and non-diabetics. However, its relationship with myocardial fibrosis in the general population remains unclear.
METHODS: The study included 2,112 participants (52%female, mean age69±9years) from the MESA cohort who had urine albumin and creatinine measurements and underwent CMR with T1-mapping for myocardial fibrosis evaluation in 2010. Analyses were stratified by sex and diabetes stage. Multivariable linear and logistic regression models assessed associations of albuminuria/albumin-creatinine ratio(ACR) with extracellular volume (ECV), native T1-time, and myocardial scar.
RESULTS: In fully adjusted models, a one-SD increase in log-transformed albumin and ACR was associated with 0.15% and 0.2% higher ECV and 2.7% and 2.6% higher native T1 time, respectively. In men, a one-SD increase in log-transformed albumin and ACR was associated with greater ECV (0.3% each) and higher native T1 time (3.3% and 2.6%, respectively). Among women, no significant associations with albuminuria or ACR were found. In participants with prediabetes, log-transformed urine albumin and ACR were positively associated with ECV (p < 0.05) but not with native T1. In diabetics, ACR showed a modest association with ECV and native T1, while log-transformed albumin was significantly associated with 0.3% greater ECV and 3% higher native T1 (p<0.05). The odds of myocardial scar were not associated with higher albumin/ACR after adjusting for CV risk factors.
CONCLUSIONS: Elevated albuminuria levels are related to subclinical fibrosis in a community-based setting, independent of traditional CV risk factors. This association was more prominent among prediabetics, diabetics and among males.
PMID:41800864 | DOI:10.1093/eurjpc/zwag137