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Medicine 2019-Mar

Predictive value of blood urea nitrogen/creatinine ratio in the long-term prognosis of patients with acute myocardial infarction complicated with acute heart failure.

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Hao Qian
Chengchun Tang
Gaoliang Yan

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At present, the long-term prognosis of patients with acute myocardial infarction (AMI) after emergency percutaneous coronary intervention is the focus of attention, and relevant research is actively investigating the risk factors associated with prognosis. Poor prognosis often exists in Patients with AMI complicated with acute heart failure (AHF). In recent years, some studies have found that blood urea nitrogen/creatinine ratio (BUN/Cr) can better predict the prognosis of patients with AHF than single BUN or Cr. The relationship between long-prognosis of patients with AMI, as one of the common causes of AHF, and BUN/Cr is unknown. The main purpose of this study was to determine whether BUN/Cr has a predictive value for long-term prognosis in patients with AMI complicated with AHF.In this study, 389 consecutive patients with AMI were enrolled. According to AHF and a median BUN/Cr at admission of 15.32, the patients were divided into four groups (non-AHF + low BUN/Cr, non-AHF + high BUN/Cr, AHF + low BUN/Cr, and AHF + high BUN/Cr groups). A 1-year follow-up was implemented, and the study endpoint was defined as all-cause mortality. Predictors associated with 1-year mortality were evaluated using the Cox proportional hazard analysis, and the Kaplan-Meier analysis was used to estimate the survival rates.AHF occurred in 163 patients (41.9%) during hospital admission and 29 patients died during the 1-year follow-up. The Cox proportional hazard analysis proved an association between the combination of AHF and high BUN/Cr and mortality; however, the association with AHF + low BUN/Cr was not statistically significant.AHF combined with elevated BUN/Cr is linked with an increased risk of mortality in patients with AMI, which suggests that BNU/Cr has a predictive value for prognosis in patients with AMI complicated with AHF.

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