Related Links
Statistics
| Number of Journals | 8 |
| Number of Issues | 59 |
| Number of Articles | 447 |
| Article View | 167,452 |
| PDF Download | 111,510 |
Asessment of blood urea nitrogen to creatinine ratio as a predictor of mortality in ST-elevation myocardial infarction patients undergoing thrombolytic therapy: a cross-sectional study | ||
| Cardiovascular Biomedicine | ||
| Volume 4, Issue 1, August 2024, Pages 31-39 PDF (436.62 K) | ||
| Document Type: original articles | ||
| DOI: 10.18502/cbj.v4i1.16225 | ||
| Authors | ||
| Haleh Bodagh1; Amin Ghanivash1; Asma Yousefzadeh1; Erfan Banisefid2; Mohammad bagher Bodagh3; Shila Mosadeghi Khiavi2; Sina Hamzehzadeh2; Sina Seifimansour4; Razieh Parizad* 1, 5 | ||
| 1Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran | ||
| 2Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran | ||
| 3Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran | ||
| 4Student Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran | ||
| 5Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran | ||
| Abstract | ||
| Objectives: Given the increasing number of ST-elevation myocardial infarction (STEMI) and the related healthcare expenses and medical outcomes, as well as the frequent occurrence of kidney problems in this patient population, the current research aims to explore the effect of blood urea nitrogen to creatinine (BUN/Cr) ratio on the in-hospital mortality (IHM) of STEMI patients undergoing thrombolytic therapy. Methods: This study is a cross-sectional analytical study conducted in 2021 at Shahid Madani Hospital, affiliated with Tabriz University of Medical Science, which investigated the relationship between the BUN/Cr ratio and IHM in patients with STEMI who received thrombolytic treatment between 2017 and 2019. Patients with other causes of ST elevation, those undergoing dialysis, or those with incomplete medical records were excluded. Data were collected from patient medical records. The primary outcome was in-hospital mortality, with secondary outcomes including the occurrence of heart failure and the need for blood transfusion—chi-square tests for categorical and t-tests for continuous variables. A p-value of less than 0.05 was considered statistically significant. Results: A total of 398 patients were diagnosed with STEMI and treated with thrombolytic 330 (82.9%) patients were men. High BUN and Cr had a significant correlation with high mortality rates (P <0.01). However, BUN/Cr didn’t have a substantial relationship with IHM and one-year mortality (P-value = 0.46). The most common in-hospital complication was heart failure (HF), and a higher need for blood transfusion was significantly related to high rates of BUN/Cr (P <0.01). Conclusions: While high BUN and Cr levels were significantly associated with increased mortality rates, the BUN/Cr ratio was not significantly related to IHM. These results suggest that although elevated BUN and creatinine indicate poor prognosis, the BUN/Cr ratio may not be a standalone predictor of in-hospital mortality. Further research is needed to validate these findings and identify other factors affecting patient outcomes. | ||
| Keywords | ||
| ST Elevation Myocardial Infarction; BUN/Cr Ratio; Thrombolytic Therapy; In -hospital mortality | ||
| References | ||
|
1.Go AS, Mozaffarian D, Roger VL, et al. Executive summary: heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399-410.
2.Taskesen T, Sekhon H, Wroblewski I, et al. Usefulness of Mean Platelet Volume to Predict Significant Coronary Artery Disease in Patients With Non-ST-Elevation Acute Coronary Syndromes.Am J Cardiol. 2017;119(2):192-196.
3.Mandelzweig L, Battler A, Boyko V, et al. The second Euro Heart Survey on acute coronary syndromes: Characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004. Eur Heart J. 2006;27(19):2285-93.
4.Cheng CL, Lee CH, Chen PS, et al. Validation of acute myocardial infarction cases in the national health insurance research database in taiwan. J Epidemiol. 2014;24(6):500-7.
5.Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340(2):115-26.
6.Luepker RV, Raczynski JM, Osganian S, et al. Effect of a community intervention on patient delay and emergency medical service use in acute coronary heart disease: The Rapid Early Action for Coronary Treatment (REACT) Trial. JAMA. 2000;284(1):60-7.
7.Stone GW, Witzenbichler B, Guagliumi G, et al. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med. 2008;358(21):2218-30.
8.Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet.2003;361(9351):13-20.
9.Steg PG, James SK, Atar D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569-619.
10.Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol.2013;62(16):e147-239.
11.Shiraishi J, Nakamura T, Shikuma A, et al. Relationship Between Mean Blood Pressure at Admission and In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction. Int Heart J. 2016;57(5):547-52.
12.Thiele H, Akin I, Sandri M, et al. PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock. N Engl J Med. 2017;377(25):2419-2432.
13.Massicotte-Azarniouch D, Kuwornu JP, Carrero JJ, et al.Incident Atrial Fibrillation and the Risk of Congestive Heart Failure, Myocardial Infarction, End-Stage Kidney Disease, and Mortality Among Patients With a Decreased Estimated GFR. Am J Kidney Dis. 2018;71(2):191-199.
14.Richter B, Sulzgruber P, Koller L, et al. Blood urea nitrogen has additive value beyond estimated glomerular filtration rate for prediction of long-term mortality in patients with acute myocardial infarction. Eur J Intern Med.2019;59:84-90.
15.Wang J, Wu X, Sun J, et al. Prediction of major adverse cardiovascular events in patients with acute coronary syndrome: Development and validation of a non-invasive nomogram model based on autonomic nervous system assessment. Front Cardiovasc Med. 2022;9:1053470.
16.Chen CY, Yoshida A, Asakura M, et al. Serum blood urea nitrogen and plasma brain natriuretic Peptide and low diastolic blood pressure predict cardiovascular morbidity and mortality following discharge in acute decompensated heart failure patients. Circ J. 2012;76(10) :2372-9.
17.Kajimoto K, Sato N, Takano T. Relation between elevated blood urea nitrogen, clinical features or comorbidities, and clinical outcome in patients hospitalized for acute heart failure syndromes.Int J Cardiol. 2015;201:311-4.
18.Hartopo AB, Puspitawati I, Anggraeni VY. High Level of Mid-Regional Proadrenomedullin during ST-Segment Elevation Myocardial Infarction Is an Independent Predictor of Adverse Cardiac Events within 90-Day Follow-Up. Medicina (Kaunas). 2022;58(7):861.
19.Smith GL, Masoudi FA, Shlipak MG, et al. Renal impairment predicts long-term mortality risk after acute myocardial infarction. J Am Soc Nephrol.2008;19(1):141-50.
20.Huang S, Guo N, Duan X, et al. Association between the blood urea nitrogen to creatinine ratio and in‑hospital mortality among patients with acute myocardial infarction: A retrospective cohort study.Exp Ther Med. 2022;25(1):36.
21.Adam AM, Nasir SAR, Merchant AZ, et al. Efficacy of serum blood urea nitrogen, creatinine and electrolytes in the diagnosis and mortality risk assessment of patients with acute coronary syndrome. Indian Heart J.2018;70(3):353-359.
22.Bataille Y, Costerousse O, Bertrand OF, et al. One-year mortality of patients with ST-Elevation myocardial infarction: Prognostic impact of creatinine-based equations to estimate glomerular filtration rate. PLoS One. 2018;13(7):e0199773.
23.Přeček J, Hutyra M, Kováčik F, et al. Biomarkers of renal function in prognostic stratification of patients with acute coronary syndrome. Cor et Vasa.2018;60(2):e148-e54.
24.Gafter U, Bessler H, Malachi T, et al. Platelet count and thrombopoietic activity in patients with chronic renal failure. Nephron. 1987;45(3):207-10.
25.Dorgalaleh A, Mahmudi M, Tabibian S, et al. Anemia and thrombocytopenia in acute and chronic renal failure. Int J Hematol Oncol Stem Cell Res. 2013;7(4):34-9.
26.Mohamed NM. Evaluation of Hemostatic Mechanism in Sudanese Renal Failure’s Patients Admitted to Khartou Admitted to Khartoum Teaching Hospital College of Medical Laboratory Science.2010;01:01. | ||
|
Statistics Article View: 248 PDF Download: 201 |
||