Prognostic Value of the Blood Urea Nitrogen-to-Albumin Ratio (BAR) for Long-Term Survival Outcomes Among ST-Segment...

The blood urea nitrogen-to-albumin ratio (BAR) has emerged as an independent prognostic marker of mortality in acute myocardial infarction (AMI). This study aimed to clarify the association between BAR and long-term survival outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).

We retrospectively analyzed 1099 consecutive STEMI patients who underwent PPCI at the First Affiliated Hospital of Kunming Medical University between June 2018 and January 2023. Kaplan-Meier survival analysis and restricted cubic splines (RCS) were used to compare mortality among patients. Cox regression and subgroup analyses were performed to assess the associations between the BAR and the prespecified endpoints. The predictive efficacy of the BAR was quantified using receiver operating characteristic (ROC) curve analysis.

Patients with higher and elevated BARs had exhibited significantly worse long-term outcomes. After adjusting for confounders, the BAR remained an independent predictor of all-cause mortality (hazard ratio (HR) = 1.118, 95% confidence interval (CI): 1.049-1.193, p = 0.001) and cardiovascular mortality (HR = 1.107, 95% CI: 1.035-1.184, p = 0.003). The areas under the ROC (AUROC) curve for the BAR was 0.720 (95% CI: 0.693-0.747) for all-cause mortality and 0.721 (95% CI: 0.694-0.747) for cardiovascular mortality.

The BAR is an independent prognostic biomarker for long-term all-cause and cardiovascular mortality in STEMI patients post-PPCI, highlighting the potential clinical utility of this ratio for in risk stratification.