Abstract 17540: The Blood Urea Nitrogen to Creatinine Ratio Has Additive Prognostic Value to Hyponatremia in Patients With Acute Decompensated Heart Failure: Data From the Korean Heart Failure (KorHF) Registry
Background: The high blood urea nitrogen to creatinine ratio (BUN/Cr) recently was known to be related with poor clinical outcomes in patients (pts) with acute decompensated heart failure (ADHF). However, the relationship between BUN/Cr and hyponatremia, another important prognostic marker in the prediction of clinical outcomes in ADHF remains unknown until now.
Methods and Results: We analyzed 2043 ADHF pts (1259 males, 68 ± 14 years old, 38.4% ischemic origin, left ventricular ejection fraction 39.0 ± 15.8%) from Korean Heart Failure (KorHF) Registry. We defined high vs. low BUN/Cr group as highest (BUN/Cr > 20.0) or lowest (BUN/Cr < 14.6) tertile and hyponatremia as sodium < 135 mmol/L. Cardiovascular (CV) event was a composite clinical endpoint of all-cause mortality and HF rehospitalization. During follow-up period (median 370, IQR 85-872 days), CV events occurred in 796 ADHF pts (39.0%) including 382 (18.7%) all-cause mortality. Hyponatremia was observed in 25.2% (n=515). The Kaplan-Meier analysis showed that high BUN/Cr with hyponatremia group had significantly higher CV events compared with other groups (50.3% vs 39.4% vs 37.6% vs 34.5%, log-rank p<0.001). In adjusted Cox proportional hazard analysis, high BUN/Cr with hyponatremia was an independent predictor of higher CV events after adjusting other HF confounding factors (HR 1.360, 95% CI 1.010-1.830, p=0.043).
Conclusion: Our study demonstrated that high BUN/Cr with hyponatremia had an independent and additive power for predicting clinical outcomes in ADHF patients. Therefore, simple, inexpensive measurements of BUN/Cr and sodium will help in the risk stratification of pts with ADHF.
- © 2013 by American Heart Association, Inc.