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

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  • Chen Chun-Yen
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital Mackay Medicine, Nursing and Management College Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital Mackay Medicine, Nursing and Management College
  • Yoshida Akemi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Asakura Masanori
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Hasegawa Takuya
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Takahama Hiroyuki
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Amaki Makoto
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Funada Akira
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Asanuma Hiroshi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Yokoyama Hiroyuki
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Kim Jiyoong
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Kanzaki Hideaki
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Kitakaze Masafumi
    Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

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Abstract

Background: Patients with heart failure (HF) have a high risk of cardiovascular (CV) death and re-hospitalization. The purpose of the present study was therefore to investigate predictors of CV death and re-hospitalization for acute decompensated HF (ADHF). Methods and Results: A total of 225 patients aged 67.2±15.2 years, including 134 men (59.6%), who were hospitalized for ADHF between 2008 and 2009, were followed up. After discharge, the relationship between clinical parameters and CV events (ie, CV death or re-hospitalization for HF) was examined. Follow-up was continued until 30 April 2011. The most important predictors of re-hospitalization were serum blood urea nitrogen (BUN; adjusted hazard ratio [HR], 1.02; 95% confidence interval [CI]: 1.00–1.03, P=0.01), plasma brain natriuretic peptide (BNP; adjusted HR, 1.85; 95% CI: 1.12–3.04, P=0.02), and diastolic blood pressure (DBP; adjusted HR, 0.97; 95% CI: 0.94–1.00, P=0.049). The only predictor of CV mortality was a high BUN (adjusted HR, 1.05; 95% CI: 1.01–1.09, P=0.01). Conclusions: High serum BUN (≥22.5mg/dl), high plasma BNP (≥250pg/ml), and low DBP (<60mmHg) predict CV events in patients hospitalized for ADHF. These factors may identify high-risk patients for CV events and provide therapeutic targets for managing HF.  (Circ J 2012; 76: 2372–2379)<br>

Journal

  • Circulation Journal

    Circulation Journal 76 (10), 2372-2379, 2012

    The Japanese Circulation Society

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