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Original Article Changes in proteinuria and the associated risks of ischemic heart disease, acute myocardial infarction, and angina pectoris in Korean population
Sung Keun Park1orcid , Ju Young Jung1orcid , Min-Ho Kim2,3orcid , Chang-Mo Oh4orcid , Eunhee Ha5orcid , Eun Hye Yang6orcid , Hyo Choon Lee6orcid , Soonsu Shin2orcid , Woo Yeon Hwang7orcid , Sangho Lee8orcid , So Youn Shin9orcid , Jae-Hong Ryoo10orcid
Epidemiol Health 2023;45e2023088-0
DOI: https://doi.org/10.4178/epih.e2023088
Published online: September 30, 2023
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1Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Preventive Medicine, Graduate School, Kyung Hee University, Seoul, Korea
3Informatization Department, Ewha Womans University Seoul Hospital, Seoul, Korea
4Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
5Department of Occupational and Environment Medicine, Ewha Womans University College of Medicine, Seoul, Korea
6Department of Occupational and Environmental Medicine, Kyung Hee University Hospital, Seoul, Korea
7Department of Obstetrics and Gynecology, Kyung Hee University Hospital, Seoul, Korea
8Department of Anesthesiology and Pain Medicine, Kyung Hee University Medical Center, Seoul, Korea
9Department of Radiology, Kyung Hee University School of Medicine, Seoul, Korea
10Department of Occupational and Environmental Medicine, Kyung Hee University School of Medicine, Seoul, Korea
Corresponding author:  Jae-Hong Ryoo,
Email: armani131@naver.com
Received: 22 December 2022   • Revised: 13 February 2023   • Accepted: 14 March 2023
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Abstract

OBJECTIVES
Proteinuria is widely used to predict cardiovascular risk. However, there is insufficient evidence to predict how changes in proteinuria may affect the incidence of cardiovascular disease.
METHODS
The study included 265,236 Korean adults who underwent health checkups in 2003-2004 and 2007-2008. They were categorized into 4 groups based on changes in proteinuria (negative: negative → negative; resolved: proteinuria ≥1+ → negative; incident: negative → proteinuria ≥1+; persistent: proteinuria ≥1+ → proteinuria ≥1+). We conducted 6 years of follow-up to identify the risks of developing ischemic heart disease (IHD), acute myocardial infarction (AMI), and angina pectoris according to changes in proteinuria. A multivariate Cox proportional-hazards model was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident IHD, AMI, and angina pectoris.
RESULTS
The IHD risk (expressed as HR [95% CI]) was the highest for persistent proteinuria, followed in descending order by incident and resolved proteinuria, compared with negative proteinuria (negative: reference, resolved: 1.211 [95% CI, 1.104 to 1.329], incident: 1.288 [95% CI, 1.184 to 1.400], and persistent: 1.578 [95% CI, 1.324 to 1.881]). The same pattern was associated with AMI (negative: reference, resolved: 1.401 [95% CI, 1.048 to 1.872], incident: 1.606 [95% CI, 1.268 to 2.035], and persistent: 2.069 [95% CI, 1.281 to 3.342]) and angina pectoris (negative: reference, resolved: 1.184 [95% CI, 1.065 to 1.316], incident: 1.275 [95% CI, 1.160 to 1.401], and persistent: 1.554 [95% CI, 1.272 to 1.899]).
CONCLUSIONS
Experiencing proteinuria increased the risks of IHD, AMI, and angina pectoris even after proteinuria resolved.

Epidemiol Health : Epidemiology and Health
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