Journals / Annals of Medical Research / 2021 / Cilt: 28 - Sayı: 10

Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)

Pages
1801–1806
Publication Date
2022-10-12
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This relationship is independent of renal dysfunction.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: Increased serum blood urea nitrogen (BUN) level is an indicator of neurohormonal and renal dysfunction, and is associated with the major adverse cardiovascular events (MACE).
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Key Findings & Data:Materials and Methods: The study consisted of 124 patients diagnosed with CTO.
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Conclusion & Impact:This relationship is independent of renal dysfunction.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Aim: Increased serum blood urea nitrogen (BUN) level is an indicator of neurohormonal and renal dysfunction, and is associated with the major adverse cardiovascular events (MACE). Chronic total occlusion (CTO) is a typical coronary artery disease diagnosed by coronary angiography. We established and tested the hypothesis that there might be a relationship between serum BUN level and long-term prognosis in patients with CTO. Materials and Methods: The study consisted of 124 patients diagnosed with CTO. The patients were followed up for a mean of 9.2 (7.4-9.5) years, and all-cause mortality was determined. Results: Patients were divided into two groups according to mortality outcome. During the follow-up, 38 of 124 patients died. Univariate Cox analysis showed that age (p=0.002), BUN (p=0.001), and serum creatinine levels (p=0.039) were associated with mortality. BUN level (OR: 1.074; 95% CI: 1.018-1.134; p=0.009) and age (OR: 1.043; 95% CI: 1.001-1.087, p=0.043) were independently associated with mortality in multivariate Cox analysis. In the ROC analysis, the AUC values for BUN and estimated glomerular filtration rate were 0.689 (p=0.002) and 0.650 (p=0.001), respectively. When the cutoff value for BUN level was considered >16 mg/ dL, the sensitivity was 68%, and the specificity was 53% (OR:1.38) to predict mortality. When the cutoff value was considered >20 mg/ dL, the sensitivity diminished to 40%, while the specificity increased to 90% (OR:3.9). Conclusion: In patients with CTO, BUN level is associated with increased all-cause mortality during long-term following. This relationship is independent of renal dysfunction.

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Cite This Article

Kiris, T., Ozyildiz, A. G., Cetin, M., Ozer, S., Duman, H. (2022). Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). Annals of Medical Research, Cilt: 28 - Sayı: 10, 1801–1806. https://ajindex.com/articles/445681

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References (13)

  1. Hosten AO. BUN and Creatinine. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations, 3rd edition. Boston: Butterworths; 1990. Chapter 193
  2. Usberti M, Federico S, Di Minno G, et al. Effects of angiotensin II on plasma ADH, prostaglandin synthesis, and water excretion in normal humans. Am J Physiol 1985;248:254-9
  3. Kato A, Klein JD, Zhang C, et al. Angiotensin II increases vasopressin-stimulated facilitated urea permeability in rat terminal IMCDs. Am J Physiol Renal Physiol 2000;279:835-40
  4. Schrier R.W., Blood urea nitrogen and serum creatinine: not married in heart failure. Circ Heart Fail 2008;1:2-5
  5. Testani JM, Cappola TP, Brensinger CP, et al. Interaction between loop diuretic-associated mortality and blood urea nitrogen concentration in chronic heart failure. J Am Coll Cardiol 2011;58:375-82
  6. Jujo K, Mianami Y, Haruki S, et al. Persistent high blood urea nitrogen level is associated with increased risk of cardiovascular events in patients with acute heart failure. ESC Heart Fail 2017;4:545-53
  7. 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
  8. Rentrop KP, Cohen M, Blanke H, et al. Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J Am Coll Cardiol 1985;5:587-92
  9. Kilian JG, Keech A, Adams MR, et al. Coronary collateralization: determinants of adequate distal vessel filling after arterial occlusion. Coron Artery Dis 2002;13:155-9
  10. Cheitlin MD, Armstrong WF, Aurigemma GP, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). Circulation 2003;108:1146-62
  11. Metkus TS, Suarez-Pierre A, Crawford TC, et al. Diastolic dysfunction is common and predicts outcome after cardiac surgery. J Cardiothorac Surg 2018;13:67
  12. Hartupee J, Mann DL. Neurohormonal activation in heart failure with reduced ejection fraction. Nat Rev Cardiol. 2017:14:30-8
  13. Rouleau JL, Moye LA, de Champlain J, et al. Activation of neurohumoral systems following acut