BLOOD UREA NITROGEN-TO-CREATININE RATIO AT ADMISSION AS A PREDICTOR OF MAJOR ADVERSE CARDIOVASCULAR EVENT WITHIN 30 DAYS IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

Abstract

An increase of BUN/Cr Ratio (BCR) shows high neurohormonal activity in patients with acute decompensated heart failure (ADHF). The value of BCR was thought to be able to predict the mortality and readmission rate. An increase of this marker was related to worse outcome during hospitalization. However, the relationship between BCR and Major Adverse Cardiovascular Events (MACEs) in ADHF still controversial. This study aimed to analyze the relationship between BCR and MACEs in ADHF patients.

Methods : Patients were recruited from July 2018 to December 2018. This prospective study involved 96 patients diagnosed with ADHF treated through the emergency unit. Variables, such as comorbidities, drug history, ejection fraction, and laboratory findings were evaluated. MACEs in this study included death, rehospitalization caused by AHF, arrhythmia and stroke. Patients were followed-up for one month since hospital admission. Bivariate analyses were done using Chi-square, independent T-test, and Mann-Whitney. A ROC analysis was performed to assess the BCR and MACEs. Logistic regression, as a multivariate analysis, was also performed in this study.

Results: From 96 patients, 47 (48.9%) patients were having MACEs. Compared to no MACEs patients, nitrate, inotropic, Hb, BUN, Cr, and CrCl were having a statistical significant in univariate analysis (p<0.25). From ROC analysis, weobtained a cut-off value of 16.05 (AUC 62.7%) with 63.8% sensitivity and 56.9% specificity to predict MACEs (p=0.032). A multivariate analysis showed BCR could be an independent variable (OR=2.47, 95% CI= 1.011-6.012; p=0.001).

Conclusion: BCR is an independent variable to predict MACEs in ADHF patients. A prospective design study with large samples was needed to validate this finding.