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Blood urea nitrogen to left ventricular ejection fraction ratio is associated with long-term mortality in the stable
A G Özyıldız1, E Kalaycıoğlu, A Özyıldız
1Department of Cardiology, Recep Tayyip Erdogan University, Training and Research Hospital, Rize, Turkey. aligokhanozyildiz@gmail.com.
Insights
The blood urea nitrogen/left ventricular ejection fraction ratio (BUNLVEFr) effectively predicts mortality and heart failure in stable angina patients. This new indicator offers superior prognostic value compared to BUN or LVEF alone.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Left ventricle (LV) dysfunction is a major cause of mortality in stable angina pectoris (SAP) patients.
- New prognostic indicators are needed to improve clinical practice for SAP management.
- Blood urea nitrogen (BUN) is increasingly recognized for its role in cardiovascular diseases, reflecting cardiac dysfunction and neurohormonal activation.
Purpose of the Study:
- To investigate the prognostic significance of the BUN/LV ejection fraction ratio (BUNLVEFr) for long-term mortality and de novo decompensated heart failure (HF) in SAP patients.
- To compare the predictive power of BUNLVEFr against BUN and LV ejection fraction (LVEF) alone.
Main Methods:
- A cohort of 603 consecutive SAP patients undergoing coronary angiography was studied.
- The median follow-up duration was 112.6 months.
- Endpoints included all-cause mortality and de novo decompensated HF.
Main Results:
- Adverse cardiac events occurred in 23.3% of patients, with 17.1% mortality and 6.3% decompensated HF.
- BUNLVEFr was identified as an independent predictor of mortality and HF (p=0.001).
- BUNLVEFr demonstrated superior predictive ability compared to BUN alone (p<0.001) and LVEF alone (p<0.001).
Conclusions:
- The BUNLVEFr ratio offers enhanced prognostic information for SAP patients compared to BUN or LVEF individually.
- This ratio may aid in refining therapeutic strategies for SAP patients.
- A BUNLVEFr >29 indicated high sensitivity for predicting mortality/HF.
Objective:
Left ventricle (LV) dysfunction remains a significant cause of morbidity and mortality in patients with stable angina pectoris (SAP) and has prognostic significance. However, new prognostic indicators may be more useful in clinical practice. There is a growing interest in the role of blood urea nitrogen (BUN) in cardiovascular diseases. Blood urea nitrogen is an indicator of cardiac dysfunction and neurohormonal activation. We aimed to determine the relationship of BUN/LV ejection fraction ratio (BUNLVEFr) with long-term mortality and de novo decompensated heart failure (HF) in SAP patients.
Patients And Methods:
The study comprised 603 consecutive SAP patients who underwent coronary angiography. The median duration of the follow-up period was 112.6±17.8 months. All-cause mortality and de novo decompensated HF were determined as the endpoints.
Results:
Adverse cardiac events were observed in 141 patients (23.3%), including mortality in 103 (17.1%) and decompensated HF in 38 (6.3%) of them during the follow-up period. Age (p=0.027), BUNLVEFr (p=0.001), glucose (p=0.043), hemoglobin (p=0.035), and Gensini score (p=0.012) were found as independent predictors of mortality and decompensated HF. BUNLVEFr was superior to BUN alone (BUNLVEFr vs. BUN: Z=5.715, p<0.001) and LVEF alone (BUNLVEFr vs. LVEF: Z=4.075, p<0.001) in predicting endpoints. In addition, BUNLVEFr >29 predicted all-cause mortality/decompensated HF with high sensitivity (78%) and low specificity (68%).
Conclusions:
BUNLVEFr may provide better prognostic information than either BUN or EF can give alone in determining therapeutic strategies for SAP patients.
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