Microalbuminuria in Ischemic Stroke

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Abstract
ALTHOUGH microalbuminuria is associated with clinical risk factors for stroke, including diabetes, hypertension, aging, history of myocardial infarction, and left ventricular hypertrophy, there is surprisingly little information regarding it as an independent risk factor for stroke or as a predictor of stroke outcome. A large prospective study1 has reported that microalbuminuria is a risk factor for stroke in men, and a limited case-control study2 found that the highest quintile of microalbuminuria values was associated with a 13-fold increased risk for stroke. Although microalbuminuria is more prevalent in diabetes and/or hypertension, 2 classic risk factors associated with intracranial arteriosclerosis, reduced microvascular perfusion, and lacunar infarcts, there is scant data regarding the incidence of microalbuminuria in lacunar stroke. More recently, a highly significant association between microalbuminuria and carotid artery intima-media thickness has been reported, a finding which suggests that microalbuminuria may be a a marker for early development of carotid artery atherosclerosis and points to a possible linkage between microalbuminuria and atherothrombotic stroke mechanism.3 With the introduction of more sensitive and relatively inexpensive dipstick methods, patients can now be readily screened for microalbuminuria, commonly defined as a urinary albumin concentration higher than 20 but not exceeding 200 mg/L.4 Our study was designed, therefore, to determine (1) the incidence of microalbuminuria in ischemic stroke, (2) its relationship to risk factors for stroke, (3) its prevalence in major subtypes of ischemic stroke, and (4) its potential use as a marker for stroke recurrence.