A high level of blood urea nitrogen is a significant predictor for in-hospital mortality in patients with acute myocardial infarction

J-MINUET investigators

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

High levels of blood urea nitrogen (BUN) have been demonstrated to significantly predict poor prognosis in patients with acute decompensated heart failure. However, this relationship has not been fully investigated in patients with acute myocardial infarction (AMI). We investigated whether a high level of BUN is a significant predictor for in-hospital mortality and other clinical outcomes in patients with AMI. The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective, observational, multicenter study conducted in 28 institutions, in which 3,283 consecutive AMI patients were enrolled. We excluded 98 patients in whom BUN levels were not recorded at admission and 190 patients who were undergoing hemodialysis. A total of 2,995 patients were retrospectively analyzed. BUN tertiles were 1.5-14.4 mg/dL (tertile 1), 14.5-19.4 mg/dL (tertile 2), and 19.5-240 mg/dL (tertile 3). Increasing tertiles of BUN were associated with stepwise increased risk of in-hospital mortality (2.5, 5.1, and 11%, respectively; P < 0.001). These relationships were also observed after adjusting for reduced estimated glomerular filtration rate (estimated GFR < 60 mL/ minute/1.73 m2) or Killip classifications. In multivariable analysis, high levels of BUN significantly predicted in-hospital mortality, after adjusting for creatinine and other known predictors (BUN tertile 3 versus 1, adjusted odds ratio [OR]: 2.59, 95% confidence interval [95% CI]: 1.57-4.25, P < 0.001; BUN tertile 2 versus 1, adjusted OR: 1.60, 95% CI: 0.94-2.73, P = 0.081). A high level of BUN could be a useful predictor of in-hospital mortality in AMI patients.

Original languageEnglish
Pages (from-to)263-271
Number of pages9
JournalInternational heart journal
Volume59
Issue number2
DOIs
Publication statusPublished - 01-01-2018

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Blood Urea Nitrogen
Hospital Mortality
Myocardial Infarction
Odds Ratio
Confidence Intervals
Patient Admission
Glomerular Filtration Rate
Multicenter Studies
Observational Studies
Registries
Renal Dialysis
Creatinine
Heart Failure

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{6db3885713be4f8c8043d7d8e9304e82,
title = "A high level of blood urea nitrogen is a significant predictor for in-hospital mortality in patients with acute myocardial infarction",
abstract = "High levels of blood urea nitrogen (BUN) have been demonstrated to significantly predict poor prognosis in patients with acute decompensated heart failure. However, this relationship has not been fully investigated in patients with acute myocardial infarction (AMI). We investigated whether a high level of BUN is a significant predictor for in-hospital mortality and other clinical outcomes in patients with AMI. The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective, observational, multicenter study conducted in 28 institutions, in which 3,283 consecutive AMI patients were enrolled. We excluded 98 patients in whom BUN levels were not recorded at admission and 190 patients who were undergoing hemodialysis. A total of 2,995 patients were retrospectively analyzed. BUN tertiles were 1.5-14.4 mg/dL (tertile 1), 14.5-19.4 mg/dL (tertile 2), and 19.5-240 mg/dL (tertile 3). Increasing tertiles of BUN were associated with stepwise increased risk of in-hospital mortality (2.5, 5.1, and 11{\%}, respectively; P < 0.001). These relationships were also observed after adjusting for reduced estimated glomerular filtration rate (estimated GFR < 60 mL/ minute/1.73 m2) or Killip classifications. In multivariable analysis, high levels of BUN significantly predicted in-hospital mortality, after adjusting for creatinine and other known predictors (BUN tertile 3 versus 1, adjusted odds ratio [OR]: 2.59, 95{\%} confidence interval [95{\%} CI]: 1.57-4.25, P < 0.001; BUN tertile 2 versus 1, adjusted OR: 1.60, 95{\%} CI: 0.94-2.73, P = 0.081). A high level of BUN could be a useful predictor of in-hospital mortality in AMI patients.",
author = "{J-MINUET investigators} and Yu Horiuchi and Jiro Aoki and Kengo Tanabe and Koichi Nakao and Yukio Ozaki and Kazuo Kimura and Junya Ako and Satoshi Yasuda and Teruo Noguchi and Satoru Suwa and Kazuteru Fujimoto and Yasuharu Nakama and Takashi Morita and Wataru Shimizu and Yoshihiko Saito and Atsushi Hirohata and Yasuhiro Morita and Teruo Inoue and Atsunori Okamura and Masaaki Uematsu and Kazuhito Hirata and Yoshisato Shibata and Michikazu Nakai and Kunihiro Nishimura and Yoshihiro Miyamoto and Masaharu Ishihara",
year = "2018",
month = "1",
day = "1",
doi = "10.1536/ihj.17-009",
language = "English",
volume = "59",
pages = "263--271",
journal = "International Heart Journal",
issn = "1349-2365",
publisher = "International Heart Journal Association",
number = "2",

}

A high level of blood urea nitrogen is a significant predictor for in-hospital mortality in patients with acute myocardial infarction. / J-MINUET investigators.

In: International heart journal, Vol. 59, No. 2, 01.01.2018, p. 263-271.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A high level of blood urea nitrogen is a significant predictor for in-hospital mortality in patients with acute myocardial infarction

AU - J-MINUET investigators

AU - Horiuchi, Yu

AU - Aoki, Jiro

AU - Tanabe, Kengo

AU - Nakao, Koichi

AU - Ozaki, Yukio

AU - Kimura, Kazuo

AU - Ako, Junya

AU - Yasuda, Satoshi

AU - Noguchi, Teruo

AU - Suwa, Satoru

AU - Fujimoto, Kazuteru

AU - Nakama, Yasuharu

AU - Morita, Takashi

AU - Shimizu, Wataru

AU - Saito, Yoshihiko

AU - Hirohata, Atsushi

AU - Morita, Yasuhiro

AU - Inoue, Teruo

AU - Okamura, Atsunori

AU - Uematsu, Masaaki

AU - Hirata, Kazuhito

AU - Shibata, Yoshisato

AU - Nakai, Michikazu

AU - Nishimura, Kunihiro

AU - Miyamoto, Yoshihiro

AU - Ishihara, Masaharu

PY - 2018/1/1

Y1 - 2018/1/1

N2 - High levels of blood urea nitrogen (BUN) have been demonstrated to significantly predict poor prognosis in patients with acute decompensated heart failure. However, this relationship has not been fully investigated in patients with acute myocardial infarction (AMI). We investigated whether a high level of BUN is a significant predictor for in-hospital mortality and other clinical outcomes in patients with AMI. The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective, observational, multicenter study conducted in 28 institutions, in which 3,283 consecutive AMI patients were enrolled. We excluded 98 patients in whom BUN levels were not recorded at admission and 190 patients who were undergoing hemodialysis. A total of 2,995 patients were retrospectively analyzed. BUN tertiles were 1.5-14.4 mg/dL (tertile 1), 14.5-19.4 mg/dL (tertile 2), and 19.5-240 mg/dL (tertile 3). Increasing tertiles of BUN were associated with stepwise increased risk of in-hospital mortality (2.5, 5.1, and 11%, respectively; P < 0.001). These relationships were also observed after adjusting for reduced estimated glomerular filtration rate (estimated GFR < 60 mL/ minute/1.73 m2) or Killip classifications. In multivariable analysis, high levels of BUN significantly predicted in-hospital mortality, after adjusting for creatinine and other known predictors (BUN tertile 3 versus 1, adjusted odds ratio [OR]: 2.59, 95% confidence interval [95% CI]: 1.57-4.25, P < 0.001; BUN tertile 2 versus 1, adjusted OR: 1.60, 95% CI: 0.94-2.73, P = 0.081). A high level of BUN could be a useful predictor of in-hospital mortality in AMI patients.

AB - High levels of blood urea nitrogen (BUN) have been demonstrated to significantly predict poor prognosis in patients with acute decompensated heart failure. However, this relationship has not been fully investigated in patients with acute myocardial infarction (AMI). We investigated whether a high level of BUN is a significant predictor for in-hospital mortality and other clinical outcomes in patients with AMI. The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective, observational, multicenter study conducted in 28 institutions, in which 3,283 consecutive AMI patients were enrolled. We excluded 98 patients in whom BUN levels were not recorded at admission and 190 patients who were undergoing hemodialysis. A total of 2,995 patients were retrospectively analyzed. BUN tertiles were 1.5-14.4 mg/dL (tertile 1), 14.5-19.4 mg/dL (tertile 2), and 19.5-240 mg/dL (tertile 3). Increasing tertiles of BUN were associated with stepwise increased risk of in-hospital mortality (2.5, 5.1, and 11%, respectively; P < 0.001). These relationships were also observed after adjusting for reduced estimated glomerular filtration rate (estimated GFR < 60 mL/ minute/1.73 m2) or Killip classifications. In multivariable analysis, high levels of BUN significantly predicted in-hospital mortality, after adjusting for creatinine and other known predictors (BUN tertile 3 versus 1, adjusted odds ratio [OR]: 2.59, 95% confidence interval [95% CI]: 1.57-4.25, P < 0.001; BUN tertile 2 versus 1, adjusted OR: 1.60, 95% CI: 0.94-2.73, P = 0.081). A high level of BUN could be a useful predictor of in-hospital mortality in AMI patients.

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