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Abstract
The microalbuminuria happens more often in diabetic patients with acute myocardial infarction (AMI) (120) but it has been reported even in non-diabetic patients with AMI. The microalbuminuria is considerable predictive factor in intra-hospital mortality (121,122), Coronary incidents and the death over longer periods after myocardial infarction (123,124). Aconsiderable higher and heavier degree of coronary disease has been Registered in patients with AMI and microalbuminuria than in patients with AMI but without microalbuminuria (125).from clinical practice point of view the investigation of microalbuminuria as a prognostic factor is of considerable importance since a lot of tests show that the microalbuminuria is a factor that could be modified. (119 According to our results, the incidence of Killip I was less common in patients without microalbuminuria in non diabetic and more significant in diabetic patients. This is in agreement with Ellekilde et al 129) who found higher levels of albumin excretion rate in acute myocardial infarction patients with heart failure compared with a group of patients without heart failure. Furthermore, Berton et al. (128) showed that a relationship exists between plasma aldosterone levels and albumin excretion rate in Killip class I patients with acute myocardial infarction. It is possible that the elevated glomerular capillary pressure, which is found in patients who develop heart failure, like the acute myocardial infarction patients with pulmonary edema, facilitates the trans-glomerular passage of albumin (130). The finding that, microalbuminuria remained a powerful prognostic indicator even if we excluded acute myocardial infarction patients with Killip class I from the analysis, may suggest that microalbuminuria is related to the adverse prognosis of acute myocardial infarction with a mechanism different from the development of congestive heart failure.