Prognostic Impact of Blood Urea Nitrogen Changes During Hospitalization in Patients With Acute Heart Failure Syndrome

• Miura Masanobu

  Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine

• Sakata Yasuhiko

  Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine

• Nochioka Kotaro

  Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine

• Takahashi Jun

  Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine

• Takada Tsuyoshi

  Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine

• Miyata Satoshi

  Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine

• Hiramoto Tetsuya

  Division of Cardiology, Osaki Citizen Hospital

• Inoue Kan-ichi

  Division of Cardiology, South Miyagi Medical Center

• Tamaki Kenji

  Division of Cardiology, Iwate Prefectural Central Hospital

• Shiba Nobuyuki

  Department of Cardiovascular Medicine, International University of Health and Welfare

• Shimokawa Hiroaki

  Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine

抄録

Background: Elevated blood urea nitrogen (BUN) observed in patients hospitalized for acute heart failure syndrome (AHFS) may represent increased neurohumoral activation. The purpose of this study was to examine the prognostic impact of BUN changes during hospitalization on the long-term prognosis of AHFS patients. Methods and Results: The Tohoku Acute Heart Failure Registry (n=497) is a multicenter retrospective cohort study enrolling AHFS patients who were admitted in 2007. The 337 survivors (mean age, 76 years; 52% male) were divided into 3 groups according to tertiles of BUN change during hospitalization: Decreased (D-BUN, ΔBUN (BUN level at discharge–BUN level at hospitalization) ≤–1.63mg/dl, n=112); Unchanged (U-BUN, ΔBUN –1.64 to 5.73mg/dl, n=113); Increased (I-BUN, ΔBUN >5.73mg/dl, n=112). The D-BUN group had higher prevalence of lowest glomerular filtration rate during hospitalization, whereas the I-BUN group had higher systolic blood pressure. During a median follow-up period of 2.3 years after discharge, the Kaplan-Meier curve showed that D-BUN and I-BUN had worse prognosis compared with U-BUN. Multivariable logistic model showed that all-cause death was more frequent in I-BUN (hazard ratio, 2.94; 95% confidence interval, 1.51–5.73; P<0.001). Subgroup analysis revealed that BUN increase during hospitalization was associated with all-cause death, regardless of renal function. Conclusions: AHFS patients with a BUN increase during hospitalization have worse long-term prognosis, independent of renal function.  (Circ J 2013; 77: 1221–1228)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 77 (5), 1221-1228, 2013

  一般社団法人 日本循環器学会

キーワード

• Acute heart failure syndrome
• Blood urea nitrogen
• Neurohumoral activation
• Renal dysfunction

詳細情報

• CRID: 1390001205105618560
• NII論文ID: 10031151384
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-12-1390
• COI: 1:CAS:528:DC%2BC3sXotFyktbs%3D
• ISSN: 13474820
• ISSN: 13469843
• PubMed: 23392088
• Web Site: https://www.jstage.jst.go.jp/article/circj/77/5/77_CJ-12-1390/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2014093380
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
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