Efficacy of serum blood urea nitrogen, creatinine and electrolytes in the diagnosis and mortality risk assessment of patients with acute coronary syndrome

Adam, Arsalan Majeed; Nasir, Syed Ali Raza; Merchant, Aleena Zehra; Rizvi, Ather Hasan; Rehan, Aiman; Shaikh, Ali Tariq; Abbas, Abdul Haseeb; Godil, Ansab; Khetpal, Akash; Mallick, Muhammad Saad Ali; Khan, Muhammad Shahzeb; Lashari, Muhammad Nawaz

doi:10.1016/j.ihj.2017.09.009

Cited by 15 publications

(9 citation statements)

References 25 publications

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“…The markers uric acid, homocysteine, hemoglobin, urea, and creatinine were associated with a higher 10year risk for MI, which agrees with the literature [23][24][25][26]. Also, the increase in WC, WHR, ApoB, and ApoB/A1 ratio was associated with a higher 10-year risk of CKD.…”

Section: Discussionsupporting

confidence: 90%

Cardiovascular Risk Prediction by the American Diabetes Association Risk-Assessment Tool and Novel and Traditional Cardiovascular Risk Factors in Young Adults With Type 1 Diabetes

Inácio¹,

Azevedo²,

Martins³

et al. 2022

Cureus

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Introduction: Cardiovascular disease is an important cause of morbidity and mortality in individuals with type 1 diabetes (T1D). The American Diabetes Association (ADA) has the ADA risk-assessment tool for cardiovascular risk (CVR) prediction in individuals with T1D. This study aims to evaluate the prevalence of novel and traditional cardiovascular risk factors (CVRF) and the CVR by the ADA risk-assessment tool: 10year risk for diabetes complications in young adults with T1D.Methods: Cross-sectional observational study of T1D individuals aged 18-40 years and T1D duration ≥1 year. The ADA risk-assessment tool was applied to predict CVR.Results: 75 individuals, 61.3% male, with a median age of 30 (26.0-36.0) and 13.0 (6.0-20.0) years of T1D duration. Hypertension was found in 16% of individuals and dyslipidemia in 75.0%. 21.3% were active smokers, 30.7% sedentary, and 42.7% were at least overweight. Most individuals had a 10-year risk <1% for all complications except myocardial infarction (MI). In individuals who were outside the honeymoon period (T1D duration ≥ 5 years), most had a 10-year risk <1% for all complications except MI and amputation. Nontraditional CVRF homocysteine, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, magnesium, and vitamin D correlated with the ADA risk-assessment tool. 10-year risk for MI ≥1% was significantly more frequent in men. Conclusion:To our knowledge, this is the first study to apply the ADA risk-assessment tool: 10-year risk for diabetes complications in T1D. Young adults with T1D have a worrying prevalence of CVRF and show suboptimal control. Most individuals with T1D duration ≥1 year have an estimated 10-year risk <1% for all complications, except for MI.Categories: Cardiology, Endocrinology/Diabetes/Metabolism, Preventive Medicine Keywords: cardiovascular risk (cvr), myocardial infarction (mi), cardiovascular disease, american diabetes association risk-assessment tool: 10-year risk for diabetes complications, cardiovascular risk factor, traditional cardiovascular risk factors, novel cardiovascular risk factors, young adult, cardiovascular risk assessment, type 1 diabetes mellitus (t1d)

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Section: Discussionsupporting

confidence: 90%

Cardiovascular Risk Prediction by the American Diabetes Association Risk-Assessment Tool and Novel and Traditional Cardiovascular Risk Factors in Young Adults With Type 1 Diabetes

Inácio¹,

Azevedo²,

Martins³

et al. 2022

Cureus

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“…Patients with elevated BUN levels on admission are several times more likely to die from CVD events. BUN is a relatively common routine test that can effectively mark high-risk patients with acute coronary syndrome (ACS) for close monitoring of any adverse vascular events [ 23 ]. Increases in BUN and creatinine are highly prevalent in patients with ACS, with one in three patients having an increased level of either BUN or creatinine.…”

Section: Discussionmentioning

confidence: 99%

Association of Blood Urea Nitrogen with Cardiovascular Diseases and All-Cause Mortality in USA Adults: Results from NHANES 1999–2006

et al. 2023

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In the general population, there is little evidence of a link between blood urea nitrogen (BUN) and long-term mortality. The goal of this study was to explore whether higher BUN concentration is a predictor of cardiovascular disease (CVD) and all-cause mortality. From 1999 to 2006, the National Health and Nutrition Examination Survey (NHANES) included 17,719 adult individuals. Death outcomes were ascertained by linkage to the database records through 31 December 2015. The Cox proportional hazard regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD and all-cause mortality in individuals. We also performed stratified analyses based on age, gender, drinking, smoking, history of hypertension and diabetes. During a mean follow-up 11.65 years, a total of 3628 deaths were documented, of which 859 were due to CVD. Participants with higher BUN had a higher risk of CVD and all-cause death compared to those with lower BUN. After multifactor adjustment for demographics, major lifestyle factors, and hypertension and diabetes history, higher BUN levels compared with lower levels were significantly associated with higher risk of CVD (HR: 1.48 [1.08, 2.02], P-trend < 0.001) and all-cause mortality (HR: 1.48 [1.28, 1.72], P-trend < 0.001). In subgroup analyses, we found that the trend in the association of BUN with the risk of death remained strong in female subjects. Greater BUN levels were linked to higher CVD and all-cause mortality in the NHANES of American adults. The importance of BUN in predicting death is supported by our research.

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“…Ren et al 38 suggested serum AKP may be a potential predictive biomarker. Adam et al 39 found that K along with BUN and creatinine (Cr) haa a strong relationship in diagnosis of ACS, espectially in mortality-risk assessment of ACS patients. High MCHC and MPV levels may be beneficial for ACS 40.…”

Section: Discussionmentioning

confidence: 99%

Acute coronary syndrome screening in patients presenting with arteriosclerosis in health check-ups: a case–control study

Yan

Liu

et al. 2022

BMJ Open

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ObjectivesThis research aimed to develop a simple and effective acute coronary syndrome (ACS) screening model in order to intervene early and focus on prevention in patients presenting with arteriosclerosis.DesignA case–control study.SettingThe study used a cross-sectional survey to collect data from 2243 patients who completed anonymous electronic medical record (EMR) data and coronary angiography was gathered at a hospital in Shandong Province between December 2013 and April 2016.ParticipantsAdults 18 years old and above diagnosed as ACS or non-ACS according to the records in hospital EMR database, and with completed basic information (age and sex).Predictors54 laboratory biomarkers and demographic factors (age and sex).Statistical analysisA dataset without missing data of all patients' laboratory indicators and demographic factors was divided into training set and validation set after being balanced. After the training set balanced, area under the curve of random forest (AUCRF) and least absolute shrinkage and selection operator (LASSO) regression were used for feature extraction. Then two set random forest models were established with the different feature sets, and the process of comparison and analysis was made to evaluate models for the optimal model including sensitivity, accuracy and AUC receiver operating characteristic curves with the internal validation set.Main outcome measuresTo establish an ACS screening model.ResultsAn RF model with 31 features selected by LASSO with an AUC of 0.616 (95% CI 0.650 to 0.772), a sensitivity of 0.832 and an accuracy of 0.714 in the validation set. The other RF model with 27 features selected by AUCRF with an AUC of 0.621 (95% CI 0.664 to 0.785), a sensitivity of 0.849 and an accuracy of 0.728 in the validation set.ConclusionsThe established ACS screening model with 27 clinical features provides a better performance for practical solution in predicting ACS.

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Efficacy of serum blood urea nitrogen, creatinine and electrolytes in the diagnosis and mortality risk assessment of patients with acute coronary syndrome

Abstract: In addition to cardiac enzymes, K along with BUN and Cr may serve as important aid in diagnosis of ACS. BUN and Cr may also serve as important tools in mortality-risk assessment of ACS patients.

Cited by 15 publications

References 25 publications

Cardiovascular Risk Prediction by the American Diabetes Association Risk-Assessment Tool and Novel and Traditional Cardiovascular Risk Factors in Young Adults With Type 1 Diabetes

Cardiovascular Risk Prediction by the American Diabetes Association Risk-Assessment Tool and Novel and Traditional Cardiovascular Risk Factors in Young Adults With Type 1 Diabetes

Association of Blood Urea Nitrogen with Cardiovascular Diseases and All-Cause Mortality in USA Adults: Results from NHANES 1999–2006

Acute coronary syndrome screening in patients presenting with arteriosclerosis in health check-ups: a case–control study

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