International journal of cardiology · 2007
Serum blood urea nitrogen and long-term mortality in acute ST-elevation myocardial infarction.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Aronson Doron, Hammerman Haim, Beyar Rafael, Yalonetsky Sergey, Kapeliovich Michael, Markiewicz Walter, Goldberg Alexander
Аннотация
INTRODUCTION: Renal dysfunction is associated with increased mortality in acute coronary syndromes and other cardiovascular diseases. The prognostic value of kidney dysfunction has been investigated using creatinine-based measures of renal function. Few data are available on the prognostic significance of blood urea nitrogen (BUN), a sensitive marker of hemodynamic alterations and renal perfusion.
METHODS: The relationship between estimated glomerular filtration rate (eGFR), BUN on admission and changes in BUN during hospital course and long-term mortality was evaluated in 1507 patients with acute ST-elevation myocardial infarction (STEMI).
RESULTS: During a median follow-up of 27 months (range, 12 to 44 months), 281 patients (18.6%) died. In multivariable Cox regression models, elevated BUN (>or=25 mg/dL) at admission was an independent predictor of mortality after adjustments for clinical variables and eGFR (adjusted hazard ratio [HR] 1.7; 95% confidence interval [CI] 1.2-2.3, P=0.0015). Similar results were obtained for elevated BUN/creatinine ratio (>or=25) at admission (adjusted HR 2.0; 95% CI 1.4-2.8; P<0.0001). An increase in BUN 50% above admission value occurred in 260 of patients (17.3%) during hospital course, and was associated with increased risk of mortality after adjustments of clinical variables, eGFR and BUN on admission (HR, 1.7 95% CI 1.3-2.2; P<0.0001).
DISCUSSION: Elevated BUN and BUN/creatinine ratio on admission are independent predictors of long-term mortality in patients with STEMI. An increase in BUN level during hospital course portends adverse outcome independent of eGFR and BUN on admission.
METHODS: The relationship between estimated glomerular filtration rate (eGFR), BUN on admission and changes in BUN during hospital course and long-term mortality was evaluated in 1507 patients with acute ST-elevation myocardial infarction (STEMI).
RESULTS: During a median follow-up of 27 months (range, 12 to 44 months), 281 patients (18.6%) died. In multivariable Cox regression models, elevated BUN (>or=25 mg/dL) at admission was an independent predictor of mortality after adjustments for clinical variables and eGFR (adjusted hazard ratio [HR] 1.7; 95% confidence interval [CI] 1.2-2.3, P=0.0015). Similar results were obtained for elevated BUN/creatinine ratio (>or=25) at admission (adjusted HR 2.0; 95% CI 1.4-2.8; P<0.0001). An increase in BUN 50% above admission value occurred in 260 of patients (17.3%) during hospital course, and was associated with increased risk of mortality after adjustments of clinical variables, eGFR and BUN on admission (HR, 1.7 95% CI 1.3-2.2; P<0.0001).
DISCUSSION: Elevated BUN and BUN/creatinine ratio on admission are independent predictors of long-term mortality in patients with STEMI. An increase in BUN level during hospital course portends adverse outcome independent of eGFR and BUN on admission.