Blood urea nitrogen-to-creatinine ratio in the general population and in patients with acute heart failure

Matsue, Y. et al. (2017) Blood urea nitrogen-to-creatinine ratio in the general population and in patients with acute heart failure. Heart, 103(6), pp. 407-413. (doi: 10.1136/heartjnl-2016-310112) (PMID:27658757)

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Abstract

Objective: The blood urea nitrogen-to-creatinine (BUN/creatinine) ratio has been proposed as a useful parameter in acute heart failure (AHF), but data on the normal range and the added value of the ratio compared with its separate components in patients with AHF are lacking. The aim of this study is to define the normal range of BUN/creatinine ratio and to investigate its clinical significance in patients with AHF. Methods: In 4484 subjects from the general population without cardiovascular comorbidities, we calculated age-specific and sex-specific normal values of the BUN/creatinine ratio, deriving a higher and lower than normal range of BUN/creatinine ratio (exceeding the 95% prediction intervals). Association of abnormal range to prognosis was tested in 2033 patients with AHF for the outcome of all-cause death through 180 days, death or cardiovascular or renal rehospitalisation through 60 days and heart failure (HF) rehospitalisation within 60 days. Results: In a cohort of patients with AHF, 482 (24.6%) and 28 (1.4%) patients with HF were classified into higher and lower than normal range groups, respectively. In Cox regression analysis, higher than normal range of BUN/creatinine ratio group was an independent predictor for all-cause death (HR: 1.86, 95% CI 1.29 to 2.66) and death or cardiovascular or renal rehospitalisation (HR: 1.37, 95% CI 1.03 to 1.82), but not for HF rehospitalisation (HR: 1.23, 95% CI 0.81 to 1.86) after adjustment for other prognostic factors including both creatinine and BUN. Conclusions: In patients with AHF, BUN/creatinine higher than age-specific and sex-specific normal range is associated with worse prognosis independently from both creatinine and BUN.

Item Type:Articles
Additional Information:The PROTECT trial was supported by NovaCardia, a subsidiary of Merck.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John and Damman, Dr Kevin
Authors: Matsue, Y., van der Meer, P., Damman, K., Metra, M., O'Connor, C. M., Ponikowski, P., Teerlink, J. R., Cotter, G., Davison, B., Cleland, J. G.F., Givertz, M. M., Bloomfield, D. M., Dittrich, H. C., Gansevoort, R. T., Bakker, S. J.L., van der Harst, P., Hillege, H. L., van Veldhuisen, D. J., and Voors, A. A.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Heart
Publisher:BMJ Publishing Group
ISSN:1355-6037
ISSN (Online):1468-201X
Published Online:22 September 2016

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