Prognostic significance of blood urea nitrogen/creatinine ratio in chronic HFpEF

Zhen, Zhe; Liang, Weihao; Tan, Weiping; Dong, Bin; Wu, Yuzhong; Liu, Chen; Xue, Rui‐De

doi:10.1111/eci.13761

Cited by 11 publications

(20 citation statements)

References 29 publications

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“…Of the 3445 participants enrolled in the TOPCAT study, we excluded (i) participants from Russia and Georgia ( n = 1678), given the significant regional difference previous described 14 ; (ii) missing haemoglobin or haematocrit at baseline ( n = 19); and (iii) and participant with obviously wrong haematocrit value ( n = 1). The remaining 1747 selected participants were included in the present analysis.…”

Section: Resultsmentioning

confidence: 99%

Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction

et al. 2023

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Aims This study aims to evaluate the prognostic value of mean corpuscular haemoglobin concentration (MCHC) on clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results We analysed HFpEF participants from the Americas in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial with available baseline data ( n = 1747). Patients were grouped into hypochromia or non‐hypochromia group according to a MCHC cut‐off level of 330 g/L. Cox proportional hazard model was used to explore the prognostic value of hypochromia on the long‐term clinical outcomes (the primary endpoint [composite of cardiovascular mortality, HF hospitalization and aborted cardiac arrest], any‐cause and HF hospitalization, all‐cause and cardiovascular mortality). Patients were further stratified according to baseline estimated glomerular filtration rate (eGFR) to explore the impact of renal dysfunction on the prognostic value of hypochromia. Baseline hypochromia was prevalent ( n = 662, 37.9%) and strongly associated with worse clinical outcomes. In patients with worse renal function (eGFR < 60 mL/min per 1.73 m 2 ), hypochromia was independently associated with primary endpoint (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.23–1.98; P < 0.001), any‐cause hospitalization (HR, 1.43; 95% CI, 1.20–1.71, P < 0.001) and HF hospitalization (HR, 1.40; 95% CI, 1.07–1.84; P = 0.015), whereas no significant association between hypochromia and these outcomes was found in patients with better renal function. Conclusions Among HFpEF patients, hypochromia (i.e. MCHC ≤ 330 g/L) is independently associated with adverse clinical outcomes, especially when in the presence of co‐morbidity renal dysfunction.

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Section: Resultsmentioning

confidence: 99%

Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction

et al. 2023

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“…Despite the value of our findings, there are some limitations in our study. First of all, we only enrolled patients with supratentorial cerebral hemorrhage, and excluded patients with the factors which may effect BUN/Cr ratio such as severe infection [38] , heart failure [39 ] and renal insufficiency.These conditions may limit the generalizability of our results to patient populations.…”

Section: Discussionmentioning

confidence: 99%

Elevated blood urea nitrogen to creatinine ratio during hospitalization is associated with 90-day poor outcome in ICH patients

Wei,

Deng,

Zhao

et al. 2023

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Background and PurposeDehydration is common in hospitalized patients and associated with poor outcome in ischemic stroke patients. Intracerebral hemorrhage patients use hyperosmolar agents frequently after admission, which may lead to dehydration. Since the blood urea nitrogen to creatinine ratio (BUN/Cr) is an indicator of dehydration, it is unknown whether there is a relationship between BUN/Cr ratio during hospitalization and clinical outcome of intracerebral hemorrhage patients.MehtodsA total of 211 patients with supratentorial cerebral hemorrhage were included. Clinical data was collected retrospectively. BUN/Cr ratio on day 7 after onset (7dBUN/Cr) was calculated. Poor outcome was defined as 90-day mRS>2. Univariate and multivariate logistic regression analyses were used to determine the relationship between 7dBUN/Cr ratio and 90-day poor outcome. Receiver operating curve was used to determine the best cutoff of 7dBUN/Cr ratio for predicting poor outcome.ResultsNIHSS score, hematoma volume and 7dBUN/Cr ratio were independently correlated with 90-day poor outcome. Under receiver operating curve, 7dBUN/Cr ratio exhibited similar prognostic capability, as compared to hematoma volume. The best cutoff for 7dBUN/Cr ratio to predict poor outcome was 22 in the hyperosmolar agents subgroup.ConclusionsElevated BUN/Cr ratio at day 7 is associated with 90-day poor outcome in ICH patients. Further prospective study will be required to confirm this result and explore the value of BUN/Cr ratio in the application of hyperosmolar agents and hydration therapy.

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“…One cohort study of 42,038 participants found a U-shaped relationship between BUN/Cre ratio and all-cause mortality in the general population, but the association of BUN/Cre ratio with CVD mortality had not been found after adjusting for potential covariates (24). Some studies have reported that BUN can be used to predict heart disease (25)(26)(27). Moreover, BUN is a more valuable predictor of acute coronary syndrome than Cre (28,29).…”

Section: Discussionmentioning

confidence: 99%

The long-term effects of blood urea nitrogen levels on cardiovascular disease and all-cause mortality in diabetes: A prospective cohort study

Liu,

Gan,

Xin

et al. 2023

Preprint

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Background The long-term effects of blood urea nitrogen(BUN) in patients with diabetes remain unknown. Current studies reporting the target BUN level in patients with diabetes are also limited. Hence, this prospective study aimed to explore the relationship of BUN with all-cause and cardiovascular mortalities in patients with diabetes. Methods In total, 10,507 participants with diabetes from the National Health and Nutrition Examination Survey (1999–2018) were enrolled. The causes and numbers of deaths were determined based on the National Death Index mortality data from the date of NHANES interview until follow-up (December 31, 2019). Multivariate Cox proportional hazard regression models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CIs) of mortality. Results After 86,601 person-years of follow-up, 2,441 deaths were documented. After adjusting for variables, the HRs of cardiovascular disease (CVD) and all-cause mortality in the highest BUN level group were 1.52 and 1.35, respectively, compared with those in the lowest BUN level group. With a one-unit increment in BUN levels, the HRs of all-cause and CVD mortality rates were 1.07 and 1.08, respectively. The results remained robust when several sensitivity and stratified analyses were performed. Moreover, BUN showed a nonlinear association with all-cause and CVD mortality. Their curves all showed that the inflection points were close to the BUN level of 5 mmol/L. Conclusion BUN had a nonlinear association with all-cause and CVD mortality in diabetes. The inflection point was at 5 mmol/L.

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Prognostic significance of blood urea nitrogen/creatinine ratio in chronic HFpEF

Cited by 11 publications

References 29 publications

Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction

Mean corpuscular haemoglobin concentration and outcomes in heart failure with preserved ejection fraction

Elevated blood urea nitrogen to creatinine ratio during hospitalization is associated with 90-day poor outcome in ICH patients

The long-term effects of blood urea nitrogen levels on cardiovascular disease and all-cause mortality in diabetes: A prospective cohort study

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