Blood urea nitrogen/creatinine ratio in heart failure: Systematic review and meta-analysis

被引:2
作者
Zhou, Yichang [1 ]
Zhao, Qin [2 ]
Liu, Zhitong [1 ]
Gao, Wen [1 ]
机构
[1] Bayannur Hosp, Cardiol Rehabil Dept, Bayannur, Inner Mongolia, Peoples R China
[2] Bayannur Hosp, Cardiol Dept, Bayannur, Inner Mongolia, Peoples R China
来源
PLOS ONE | 2024年 / 19卷 / 05期
关键词
PRESERVED EJECTION FRACTION; RENAL DYSFUNCTION PHENOTYPE; CREATININE RATIO; MORTALITY; NITROGEN; RISK; KIDNEY;
D O I
10.1371/journal.pone.0303870
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
The meta-analysis is to evaluate the predictive value of the blood urea nitrogen / creatinine ratio (BCR) for long-term outcomes in patients with heart failure (HF). PubMed, EMBASE, the Cochrane library, and Web of Science were searched for relevant studies from inception to October 2023. STATA SE 14.0 software was used for statistical analysis. A total of 2036 reports were identified with 14 studies meeting pre-designed inclusion criteria. Three long-term outcomes were investigated. In patients with HF, the increase of BCR level indicated a greater risk of all-cause mortality (HR = 1.67, 95% CI 1.38-2.00; I2 = 90.8%, P = 0.000). The acute HF (AHF) subgroup demonstrated a higher risk of all-cause mortality (HR = 1.79, 95% CI 1.15-2.79; I2 = 93.9%, P = 0.000) as did the non-AHF subgroup (HR = 1.51, 95% CI 1.34-1.71; I2 = 37.1%, P = 0.122). The subgroup (<= 70 years old) demonstrated a lower risk of all-cause mortality in patients with HF (HR = 1.62, 95% CI 1.35-1.94; I2 = 68.3%, P = 0.004) as did the subgroup (> 70 years old) (HR = 1.67, 95% CI 1.19-2.34; I2 = 88.3%, P = 0.000). In addition, this study did not support the predictive value of BCR in CVD mortality (HR = 1.48, 95% CI 0.91-2.43; I2 = 63%, P = 0.100) and HF hospitalization (HR = 1.28, 95% CI 0.73-2.24; I2 = 77.5%, P = 0.035). Sensitivity analysis showed that all the results were robust. In summary, the results showed that the blood urea nitrogen / creatinine ratio (BCR) had a significant predictive value for all-cause mortality in patients with heart failure and was a fairly promising predictor obviously. Moreover, more studies are needed to further determine the predictive value of BCR in other long-term outcomes such as CVD mortality, HF hospitalization or aborted cardiac arrest.
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页数:14
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共 34 条
[1]   Elevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failure [J].
Aronson, D ;
Mittlernan, MA ;
Burger, AJ .
AMERICAN JOURNAL OF MEDICINE, 2004, 116 (07) :466-473
[2]   OPERATING CHARACTERISTICS OF A BANK CORRELATION TEST FOR PUBLICATION BIAS [J].
BEGG, CB ;
MAZUMDAR, M .
BIOMETRICS, 1994, 50 (04) :1088-1101
[3]   The risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio [J].
Brisco, Meredith A. ;
Zile, Michael R. ;
ter Maaten, Jozine M. ;
Hanberg, Jennifer S. ;
Wilson, F. Perry ;
Parikh, Chirag ;
Testani, Jeffrey M. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2016, 215 :521-526
[4]   Blood Urea Nitrogen/Creatinine Ratio Identifies a High-Risk but Potentially Reversible Form of Renal Dysfunction in Patients With Decompensated Heart Failure [J].
Brisco, Meredith A. ;
Coca, Steven G. ;
Chen, Jennifer ;
Owens, Anjali Tiku ;
McCauley, Brian D. ;
Kimmel, Stephen E. ;
Testani, Jeffrey M. .
CIRCULATION-HEART FAILURE, 2013, 6 (02) :233-239
[5]   Influence of renal dysfunction phenotype on mortality in decompensated heart failure with preserved and mid-range ejection fraction [J].
Casado, Jesus ;
Sanchez, Marta ;
Garces, Vanesa ;
Manzano, Luis ;
Manuel Cerqueiro, Jose ;
Epelde, Francisco ;
Garcia-Escriva, David ;
Perez-Silvestre, Jose ;
Morales, Jose Luis ;
Montero-Perez-Barquero, Manuel .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2017, 243 :332-339
[6]   Association of arginine vasopressin with low atrial natriuretic peptide levels, left ventricular remodelling, and outcomes in adults with and without heart failure [J].
Chirinos, Julio A. ;
Sardana, Mayank ;
Oldland, Garrett ;
Ansari, Bilal ;
Lee, Jonathan ;
Hussain, Anila ;
Mustafa, Anique ;
Akers, Scott R. ;
Wei, Wen ;
Lakatta, Edward G. ;
Fedorova, Olga V. .
ESC HEART FAILURE, 2018, 5 (05) :912-920
[7]   The Cardiorenal Syndrome in Heart Failure [J].
Costanzo, Maria Rosa .
HEART FAILURE CLINICS, 2020, 16 (01) :81-+
[8]   Bias in meta-analysis detected by a simple, graphical test [J].
Egger, M ;
Smith, GD ;
Schneider, M ;
Minder, C .
BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7109) :629-634
[9]   Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology [J].
Gorter, Thomas M. ;
van Veldhuisen, Dirk J. ;
Bauersachs, Johann ;
Borlaug, Barry A. ;
Celutkiene, Jelena ;
Coats, Andrew J. S. ;
Crespo-Leiro, Marisa G. ;
Guazzi, Marco ;
Harjola, Veli-Pekka ;
Heymans, Stephane ;
Hill, Loreena ;
Lainscak, Mitja ;
Lam, Carolyn S. P. ;
Lund, Lars H. ;
Lyon, Alexander R. ;
Mebazaa, Alexandre ;
Mueller, Christian ;
Paulus, Walter J. ;
Pieske, Burkert ;
Piepoli, Massimo F. ;
Ruschitzka, Frank ;
Rutten, Frans H. ;
Seferovic, Petar M. ;
Solomon, Scott D. ;
Shah, Sanjiv J. ;
Triposkiadis, Filippos ;
Wachter, Rolf ;
Tschoepe, Carsten ;
de Boer, Rudolf A. .
EUROPEAN JOURNAL OF HEART FAILURE, 2018, 20 (01) :16-37
[10]   2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines [J].
Hunt, Sharon Ann ;
Abraham, William T. ;
Chin, Marshall H. ;
Feldman, Arthur M. ;
Francis, Gary S. ;
Ganiats, Theodore G. ;
Konstam, Marvin A. ;
Mancini, Donna M. ;
Michl, Keith ;
Oates, John A. ;
Rahko, Peter S. ;
Silver, Marc A. ;
Stevenson, Lynne Warner ;
Yancy, Clyde W. ;
Jessup, Mariell ;
Casey, Donald E. .
CIRCULATION, 2009, 119 (14) :E391-E479