{'fraction_non_alphanumeric': 0.026869158878504672, 'fraction_numerical': 0.004672897196261682, 'mean_word_length': 5.368029739776952, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Microalbuminuria as a potential novel cardiovascular biomarker in patients with COPD

Chronic obstructive pulmonary disease (COPD) is now recognised as the third cause of death in the world [1]. Patients with COPD are more likely to have pre-existing cardiovascular disease (CVD) and are at high risk of acute events, hospitalisations and death from CVD [2, 3]. Furthermore, this strong association is independent of the degree of airflow limitation. Because of this, the Global Initiative for Chronic Obstructive Lung Disease initiative recognises CVD as the most important disease coexisting with COPD and suggests it should be routinely looked for, but makes no recommendation on how to do it [4].

Over the past two decades, interest in CVD prevention has expanded and now promotes not only primary prevention, but also identification of factors that could help clarify CVD pathophysiology, offer targets for intervention or lead to improved risk stratification beyond that allowed by the Framingham equations [5]. Currently, only a few biomarkers have been accepted as being clinically useful [6]. In this regard, the recent consensus of the American College of Cardiology/American Heart Association recognises family history as being useful and haemoglobin A1c measurement as reasonable in all adults. They also categorise microalbuminuria (MAB) assessment as reasonable in adults with hypertension or diabetes [7].

The discovery of novel “biomarkers” that could help identify cardiovascular risk in patients with COPD could help personalise therapy for that particular phenotype. To be clinically useful, the biomarker should be inexpensive, noninvasive and easily measurable. Therefore, MAB could be a …