Preoperative blood urea nitrogen-to-left ventricular ejection fraction ratio is an independent predictor of long-term major adverse cardiac events in patients undergoing coronary artery bypass grafting surgery

Abstract

Background Long-term mortality rate following coronary artery bypass grafting (CABG) procedure is still considered to be high despite advances in surgical techniques and perioperative management. Identifying high-risk patients by using cost-effective and clinically useful parameters is needed. Methods Patients who were admitted to our cardiology clinic with the diagnosis of coronary artery disease and underwent CABG between January 2008 and August 2010 were included. Study patients were followed-up for 112.6 ± 17.8 months for major adverse cardiac events (MACE) which were defined as all-cause mortality and new-onset decompensated heart failure (HF). Results Patients in MACE (+) group were older ( p < 0.001), had higher additive Euroscore ( p < 0.001), and lower left ventricular ejection fraction ( p < 0.001). Multivariate Cox regression analysis showed that additive Euroscore [odds ratio (OR) = 1.601; 95% confidence interval (CI) = 1.374–1.864; p < 0.001)] and blood urea nitrogen-to-left ventricular ejection fraction ratio (BUNEFr; OR = 1.028; 95% CI = 1.006–1.050; p = 0.011) independently predicted MACE. Receiver operating characteristic curve analysis demonstrated that BUNEFr had an area under curve of 0.794 and BUNEFr >33 had a sensitivity and specificity of 74% and 64%, respectively. Conclusion BUNEFr is a clinically useful and cost-effective parameter for the prediction of long-term mortality and new-onset decompensated HF in patients undergoing CABG.

Blood Urea Nitrogen-to-Albumin Ratio in Predicting Long-Term Mortality in Patients Following Coronary Artery Bypass Grafting: An Analysis of the MIMIC-III Database

“…Of note, the recent evidence suggested that serum elevation of BUN predicted a worse outcome in patients with acute MI, acute coronary syndrome, and following elective percutaneous coronary procedures (18)(19)(20). Recent work reported that BUN-to-left ventricular ejection fraction (LVEF) ratio independently predicted the incidence of long-term major adverse cardiac events (MACEs) including mortality and newonset decompensated HF in patients undergoing CABG (21).…”

“…Arnan and his colleagues identified that postoperative BUN was a marker of stroke risk following cardiac surgical procedures (21). Liu et al observed that BUN could predict the in-hospital mortality of patients with acute aortic dissection (AAD) (7).…”

Relationship between Blood Urea Level and Left Ventricular Ejection Fraction (LVEF) in Patients with ST-Elevation Myocardial Infarction

“…Dengan demikian, urea darah mungkin mencerminkan disregulasi neurohormonal pada pasien dengan fraksi ejeksi ventrikel kiri (LVEF) yang menurun. 4 Osmolalitas plasma yang terdiri dari kadar glukosa darah, ureum darah, dan natrium yang sebelumnya telah dipelajari dan memiliki nilai yang baik dalam memrediksi prognosis pasien AMI seharusnya dapat memberikan gambaran yang lebih baik untuk prognosis pasien. 5 Fraksi ejeksi ventrikel kiri (LVEF) yang menurun dikaitkan dengan kematian yang lebih besar di antara pasien dengan STEMI.…”

Blood urea nitrogen to left ventricular ejection fraction ratio: a predictor of in-hospital outcomes in STEMI patients

“…Blood urea nitrogen (BUN) is a surrogate of renal dysfunction and was shown to be superior to creatinine for the evaluation of prognosis in AMI patients [10] ; left ventricular ejection fraction (LVEF) is the most commonly used index to re ect the cardiac function [11] . In recently years, a new index, BUN to LVEF ratio (BLR), has been proposed to evaluate the outcome in patients with cardiovascular diseases [12][13][14][15] . However, no studies, to the best of our knowledge, have been explicitly designed to assess the short term prognostic value of BLR in STEMI patients.…”