Blood urea nitrogen level may predict readmissions, mortality in HFpEF patients: Study

Japan: In a new study published in the International Journal of Cardiology, it was found that regardless of the renal function, blood urea nitrogen (BUN) was a meaningful measure for the composite of mortality and heart failure (HF) readmission and also was linked with left atrial function in HF with preserved ejection fraction (HFpEF) patients. 

Blood urea nitrogen levels indicate a reduction in glomerular filtration rate (GFR). The influence of BUN on clinical outcomes in heart failure patients with maintained ejection fraction, excluding the effects of GFR, is uncertain. Masamichi Yano and colleagues undertook this study to assess the link between BUN and heart failure and its subtypes.

This prospective, multicenter research recruited HFpEF (50 percent left ventricular ejection fraction) patients hospitalized owing to acute decompensated heart failure from the PURSUIT-HFpEF registry. To rule out the influence of renal function on BUN levels, propensity score matching was used with factors related to GFR. The incidence of all-cause mortality and HF readmission among patients stratified by BUN, as well as the relationship between BUN and echocardiographic parameters in HFpEF patients, were investigated.

The key findings of this study were as follows:

1. This experiment had a total of 1029 subjects.

2. In this investigation, the BUN cut-off value was 24.4 mg/dL, which was also the median value in the whole population.

3. After 1:1 propensity score matching, the high and low BUN groups each included 193 patients.

4. The average period of follow-up was 401 days, and the composite endpoint occurred in 129 individuals (33.4% ).

5. In the propensity score-matched pairings, the high BUN group had a substantially higher risk of the composite endpoint than the low group.

6. Multiple regression analyses employing echocardiographic data revealed a substantial correlation between BUN and left atrial volume index.

In conclusion, according to the findings of this study, high BUN was related to the composite of all-cause mortality and HF readmission in HFpEF.

Reference:

Yano, M., Nishino, M., Ukita, K., Kawamura, A., Nakamura, H., Matsuhiro, Y., Yasumoto, K., Tsuda, M., Okamoto, N., Matsunaga-Lee, Y., Egami, Y., Tanouchi, J., … Sakata, Y. (2022). Clinical impact of blood urea nitrogen, regardless of renal function, in heart failure with preserved ejection fraction. In International Journal of Cardiology. Elsevier BV. https://doi.org/10.1016/j.ijcard.2022.06.061