A High Level of Blood Urea Nitrogen Is a Significant Predictor for In-hospital Mortality in Patients with Acute Myocardial Infarction

Horiuchi, Yu; Aoki, Jiro; Tanabe, Kengo; Nakao, Kōichi; Ozaki, Yukio; Kimura, Kazuo; Ako, Junya; Yasuda, Satoshi; Noguchi, Teruo; Suwa, Satoru; Fujimoto, Kazuteru; Nakama, Yasuharu; Morita, Takashi; Shimizu, Wataru; Saito, Yoshihiko; Hirohata, Atsushi; Morita, Yasuhiro; Inoue, Teruo; Okamura, Atsunori; Uematsu, Masaaki; Hirata, Kazuhito; Shibata, Yoshisato; Nakai, Michikazu; Nishimura, Kunihiro; Miyamoto, Yoshihiro; Ishihara, Masaharu

doi:10.1536/ihj.17-009

Cited by 45 publications

(44 citation statements)

References 30 publications

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“…Urea-BUN is a marker for both neurohormonal activity and renal function because reabsorption of urea varies not only with the renal route but also with endocrine disorders [21]. High urea levels are known to be associated with mortality in cardiovascular disorders [22]. In our study, urea values at the time of admission were higher in patients with PCAS in the group associated with mortality (61,54±41,84), significantly lower in the group without mortality (29,75± 21,48) (P <0.05).…”

Section: Discussionmentioning

confidence: 99%

“…Cr values were similar in both groups from the time of arrival (P>0.05) ( Table 1). The reason for this is thought to be the activation of renin-angiotensin-aldosterone and sympathetic nervous systems caused by low cardiac output, renal hypoperfusion, decreased GFR and renal hypoperfusion in patients with PCAS [22]. This also affects serum Cr levels.…”

Section: Discussionmentioning

confidence: 99%

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The Relationship Between Hematological Parameters and Mortality in Cardiovascular Patients With Postcardiac Arrest Syndrome

Erol¹,

Kankılıç²,

Kaya³

et al. 2019

Cureus

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Background: Post-cardiac arrest syndrome is the insufficiency of cardiac and cerebral functions caused by ischemia after sudden cardiac arrest. We aimed to determine the hematological parameters associated with mortality in the intensive care follow-up of patients with postcardiac arrest syndrome. Methods: The hematological parameters of 285 cardiovascular patients who were admitted to the emergency department of Harran University Medical Faculty between 2013 and 2018 and followed up in the intensive care unit with post-cardiac arrest syndrome were examined. A total of 85 patients were included in the study. These parameters were recorded as the time of arrival to the emergency department (0 hour) and hematological parameters at the 24 th and 48 th hours of intensive care follow-up. Results: In the mortality group, albumin (P:0.030), hemoglobin (Hg) (P: 0.049), and hematocrit (HCT) (P: 0.020) values in the blood parameters, at the time of admission to the emergency department, were significantly lower than those in the survival group. Red blood cell distribution width (RDW) (P: 0.009) and urea (P <0.001) values at the time of arrival were higher than the survival group. In the 24 th and 48 th hours, mean hemoglobin (MCHC) (P <0.05) values were lower and RDW (P <0.05) values were higher in the mortality group compared to the survival group. Conclusions: In this retrospective validation, low albumin, Hg, HCT, MCHC, and high RDW and urea levels may increase mortality in cardiovascular patients who develop post-cardiac arrest syndrome within the first 48 hours. Correcting these values early may reduce mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Relationship Between Hematological Parameters and Mortality in Cardiovascular Patients With Postcardiac Arrest Syndrome

Erol¹,

Kankılıç²,

Kaya³

et al. 2019

Cureus

View full text Add to dashboard Cite

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“…Coronary artery disease (CAD) is one of the major contributors of morbidity and mortality burden [1]. Within the spectrum of CAD, ST elevation myocardial infarction (STEMI) represents the major risk for adverse events and mortality [2].…”

Section: Introductionmentioning

confidence: 99%

“…The relationship between renal dysfunction and increased mortality in STEMI patients is well established, and renal function estimation is mandatory to risk stratify STEMI patients [2]. Estimated glomerular filtration ratio (eGFR) by the Modification of Diet in Renal Disease equation has been correlated with prognosis of STEMI patients [5], and eGFR from Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has been validated as a more simple and accurate marker of renal function [6].…”

Section: Introductionmentioning

confidence: 99%

Estimated glomerular filtration rate as one of the main predictors of in-hospital mortality in Egyptian patients with ST elevation myocardial infarction: a two-year retrospective study

et al. 2020

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Background: Renal dysfunction is one of the major causes of in-hospital mortality in STEMI patients. In this study, we evaluated the combined predictive value of eGFR by CKD-EPI equation and shock index for in-hospital mortality and other adverse clinical outcomes in Egyptian patients with STEMI. Results: A total of 450 STEMI patients were divided into 2 groups according to their eGFR with a cutoff value of 60 ml/min/1.73 m 2 and compared as regards mortality, major bleeding, reinfarction, development of heart failure, stroke, and atrial fibrillation during the period of admission. Univariate analysis was performed to define significant factors that affected mortality; then, significant factors were subjected to a multivariate logistic regression. Patients with eGFR < 60 ml/min/1.73 m 2 had higher rates of mortality (P < 0.0005) and atrial fibrillation (P = .006) during the hospital admission. A multivariate logistic regression model showed the predictors of mortality were factors SI (OR = 28.56, 95% CI 8-101.97, P < 0.0001), cardiac troponin (OR = 2.89, 95% CI 1.08-7.77, P = 0.03), age (OR = 1.07, 95% CI 1.02-1.2, P = 0.002), and eGFR (OR = 0.98, 95% CI 0.96-0.99, P = 0.04). Conclusions: Estimated GFR < 60 ml/min/1.73 m 2 in STEMI patients is associated with higher rate of mortality. Estimated GFR, age, shock index, and cardiac troponin were the most significant predictors of mortality in STEMI patients

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“…These results confirm and extend previous studies showing the impact of patient characteristics on the clinical outcomes of ACS patients. [1][2][3]15,19,20) The appropriateness of follow-up CAG: The appropriateness of routine follow-up CAG remains controversial, with a range of reports yielding contradictory findings. Although some reports point to an association between asymptomatic restenosis at routine follow-up CAG and long-term mortality, 21) others have failed to identify a meaningful association.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Temporal Distribution of Coronary Artery Disease Progression on Subsequent Consequences in Patients with Acute Coronary Syndrome

Nakatani¹,

Fukui

Kato

et al. 2019

Int. Heart J.

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The late consequences of acute coronary syndrome (ACS) have been underestimated. We hypothesized that the temporal distribution of the clinically silent coronary artery disease progression (CP) is associated with the subsequent consequences of ACS.We studied 243 patients (202 men, 64 10 years) with ACS undergoing percutaneous coronary intervention (PCI) during initial hospitalization. All patients underwent serial coronary angiograms (CAGs) immediately before PCI and at 7 3 and 60 10 months after presentation. CP was defined as an increase !15% in stenosis severity of the lesion between 2 serial CAGs. The impact of CP between each 2 serial CAGs on subsequent major adverse cardiovascular and cerebrovascular events (MACCEs) after the final CAG was examined using multivariate Cox and propensity-matched analyses.During the median follow-up duration after the final CAG of 67 months, 76 MACCEs (31.3%) were observed. Multivariate Cox proportional hazards analysis revealed that CP between the first and second CAGs (hazard ratio [HR], 2.28; 95% confidence interval [CI], 1.32-3.94; P = 0.003) and CP between the second and final CAGs (HR, 1.96; 95% CI, 1.20-3.21; P = 0.008) were independently associated with a higher rate of MACCEs beyond the final CAG. Consistent results were obtained in the propensity score-matched analyses.CP in both the early (0-7 months) and late phases (7-60 months) were independently associated with subsequent clinical events. This may indicate the prognostic significance of persistent widespread coronary disease activity following presentation in patients with ACS undergoing PCI.(Int Heart J 2019; 60: 287-295)

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A High Level of Blood Urea Nitrogen Is a Significant Predictor for In-hospital Mortality in Patients with Acute Myocardial Infarction

Cited by 45 publications

References 30 publications

The Relationship Between Hematological Parameters and Mortality in Cardiovascular Patients With Postcardiac Arrest Syndrome

The Relationship Between Hematological Parameters and Mortality in Cardiovascular Patients With Postcardiac Arrest Syndrome

Estimated glomerular filtration rate as one of the main predictors of in-hospital mortality in Egyptian patients with ST elevation myocardial infarction: a two-year retrospective study

Impact of the Temporal Distribution of Coronary Artery Disease Progression on Subsequent Consequences in Patients with Acute Coronary Syndrome

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