Predictive Value of Blood Urea Nitrogen to Albumin Ratio in Long-Term Mortality in Intensive Care Unit Patients with Acute Myocardial Infarction: A Propensity Score Matching Analysis

Zhao, Diming; Liu, Yilin; Chen, Shanghao; Xu, Zuowei; Yang, Xiaomei; Shen, Hechen; Zhang, Shijie; Yi, Li; Zhang, Haizhou; Ma, Xiaochun

doi:10.2147/ijgm.s349722

Cited by 11 publications

(7 citation statements)

References 47 publications

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“…Recently, BAR has been used as a new biomarker to assess the prognosis of various diseases and is an important prognostic factor for death in several diseases, such as pulmonary embolism, 25 sepsis, 9 and lung cancer 26 . Moreover, numerous studies have identified BAR as an independent predictor for mortality risk of AMI 30,39 . In present study, we observed significantly higher BAR levels in patients with LVA.…”

Section: Discussionsupporting

confidence: 65%

Urea nitrogen‐to‐albumin ratio predicts ventricular aneurysm formation in ST‐segment elevation myocardial infarction

Zhang,

Yang,

et al. 2024

ESC Heart Failure

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AimsLeft ventricular aneurysm (LVA) is an important complication of acute myocardial infarction. The aim of this study was to investigate the possible predictive value of blood urea nitrogen‐to‐albumin ratio (BAR) for the LVA formation in acute ST‐segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (PCI).Methods and resultsA total of 1123 consecutive patients with STEMI were prospectively enrolled. The clinical and laboratory data were compared between LVA group and non‐LVA group. Multivariable logistic regression analysis was performed to assess the independent risk factors of LVA formation. Predictive power of BAR and composite variable for LVA formation were assessed using receiver operating characteristic curve. LVA was detected in 162 patients (14.4%). The BAR was significantly higher in patients with LVA [0.16 (0.13–0.19) vs. 0.13 (0.10–0.17), P < 0.001]. Multivariable logistic regression analysis revealed that left ventricular ejection fraction (LVEF) [odds ratio (OR) = 0.865, P < 0.001], culprit vessel–left anterior descending artery (LAD) (OR = 4.705, P < 0.001), and BAR (OR = 2.208, P = 0.018) were all independent predictors for LVA formation. The predictive value of BAR remained significant even after cross‐validation by splitting population into training set (OR = 1.957, P = 0.034) and validation set (OR = 1.982, P = 0.039). The maximal length and width of LVA were significantly increased in patients with BAR ≥ 0.15 when compared with BAR < 0.15 (3.37 ± 1.09 vs. 2.92 ± 0.93, P = 0.01, for maximal length, and 2.20 ± 0.55 vs. 1.85 ± 0.63, P = 0.001, for maximal width). The discriminant power of BAR for LVA is 0.723, which is superior to both blood urea nitrogen (C statistic = 0.586, P < 0.001) and albumin (C statistic = 0.64, P < 0.001). The combination of BAR, LVEF, and culprit vessel–LAD could significantly increase the predictive ability (C statistic = 0.874, P < 0.001, for vs. BAR). Subgroup analysis of age, sex, hypertension, diabetes, smoking, LVEF, serum albumin, multiple‐vessel disease, and Gensini score had no effect on the association between BAR and risk of LVA formation (P < 0.05 for all subgroups).ConclusionsA higher BAR was an independent predictor for LVA formation in STEMI patients with primary PCI.

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Section: Discussionsupporting

confidence: 65%

Urea nitrogen‐to‐albumin ratio predicts ventricular aneurysm formation in ST‐segment elevation myocardial infarction

Zhang,

Yang,

et al. 2024

ESC Heart Failure

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“…15 In the retrospective study of Zhao et al in 1827 patients diagnosed with acute myocardial infarction in 2022; they concluded that BAR was calculated as 11.06 (7-18.59) (p<0.001) in the mortality group and 10.42 (7-16.71) in the fouryear mortality group, and that a higher BAR value could be used as an independent predictor for four-year mortality. 18 In a study by Lee et al in patients with lower GI bleeding in 2021, BUN ≥ 30 mg/dL and albumin ≤ 3.0 g/dL were associated with all-cause mortality. 19 In the study of Bae et al, the data of 596 geriatric patients with GI bleeding were analyzed and BAR and AIMS65 scores were compared.…”

Section: Discussionmentioning

confidence: 97%

Predictive value of blood urea nitrogen to serum albumin ratio in estimating in-hospital mortality in patients with upper gastrointestinal bleeding

Kurt¹,

Kurt²

2022

Eur J Clin Exp Med

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Introduction and aim. The aim of this study was to examine the usability of blood urea nitrogen to serum albumin ratio (BAR) as a prognostic predictor of in-hospital mortality in patients with gastrointestinal (GI) bleeding. Material and methods. The electronic medical records of the patients who applied to the emergency department due to upper GI bleeding during the study period were reviewed. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate each discriminant cut-off value to estimate mortality. Results. The study included 225 patients. The median (IQR) age of the patients was 75.0 (68.0–84.0) and 94 (41.8%) were female. AUC was determined as 0.784±0.055 (95% CI, 0.677–0.892) for BAR (p<0.001) in terms of in-hospital mortality. The cut-off value of BAR for this outcome was calculated as 16.26. In this cut-off value, sensitivity was 71.43%, specificity 82.84%, positive predictive value (PPV) 30.00% and negative predictive value (NPV) 96.57%. Conclusion. BAR is a useful tool that can be used to predict the in-hospital mortality of patients with GI bleeding. Patients with GI bleeding with a BAR above 16.26 will require more aggressive and timely intervention.

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“…In another study in which the prognostic value of the BAR was compared with the acute physiology score III, systemic inflammatory response syndrome and sequential organ failure assessment in patients with acute myocardial infarction, it was found that the AUC value of the BAR was higher compared with these scores. 38 In our study, the cut-off value for the BAR was determined as 4.…”

Section: Discussionmentioning

confidence: 98%

BUN/albumin ratio predicts short-term mortality better than SYNTAX score in ST-elevation myocardial infarction patients

Balcik

Satar

Gülen

et al. 2023

Journal of Cardiovascular Medicine

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ObjectiveThe aim of the study is to compare the prognostic power of the BUN/albumin ratio (BAR) calculated on admission to the emergency department and the SYNergy between Percutaneous Coronary Intervention with TAXus (SYNTAX) score calculated after coronary angiography (CAG) in predicting 30-day mortality in patients with ST-segment elevation myocardial infarction (STEMI).Method and MaterialThe study was conducted prospectively between March 2021 and March 2022 in the emergency department of a tertiary hospital. Patients over the age of 18 who underwent CAG with a diagnosis of STEMI were included in the study. Demographic charecteristics, comorbidities, laboratory parameters of the patients at the time of admission and SYNTAX (SX) score were recorded in the data form.ResultsA total of 1147 patients (77% male) diagnosed with STEMI were included in the study. When the receiver-operating characteristic analysis for SX score and laboratory parameters’ power to predict mortality was examined, it was found that the AUC value of the BAR level (AUC: 0.736; 95% confidence interval: 0.670–0.802, P < 0.001) was the highest. If the threshold value of the serum BAR level, which was determined to predict mortality, was taken as 4, the sensitivity was found to be 76.7% and the specificity was 56.9%. With multivariate logistic analysis, it was determined that the risk of mortality increased by 1.25 for each unit increase in the BAR value in STEMI patients (P < 0.001).ConclusionAccording to the study data, the BAR may guide the clinician in the early period as a practical and valuable predictor of 30-day mortality in patients diagnosed with STEMI.

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Predictive Value of Blood Urea Nitrogen to Albumin Ratio in Long-Term Mortality in Intensive Care Unit Patients with Acute Myocardial Infarction: A Propensity Score Matching Analysis

Cited by 11 publications

References 47 publications

Urea nitrogen‐to‐albumin ratio predicts ventricular aneurysm formation in ST‐segment elevation myocardial infarction

Urea nitrogen‐to‐albumin ratio predicts ventricular aneurysm formation in ST‐segment elevation myocardial infarction

Predictive value of blood urea nitrogen to serum albumin ratio in estimating in-hospital mortality in patients with upper gastrointestinal bleeding

BUN/albumin ratio predicts short-term mortality better than SYNTAX score in ST-elevation myocardial infarction patients

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