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
N1 - Funding Information:
From the 1Mitsui Memorial Hospital, Tokyo, 2Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, 3Fujita Health University Hospital, Aichi, 4Yokohama City University Medical Center, Kanagawa, 5Kitasato University, Kanagawa, 6National Cerebral and Cardiovascular Center, Osaka, 7Juntendo University Shizuoka Hospital, Shizuoka, 8National Hospital Organization Kumamoto Medical Center, Kumamoto, 9Hiroshima City Hospital, Hiroshima, 10Osaka General Medical Center, Osaka, 11Nippon Medical School, Tokyo, 12Nara Medical University, Nara, 13The Sakakibara Heart Institute of Okayama, Okayama, 14Ogaki Municipal Hospital, Gifu, 15Dokkyo Medical University, Tochigi, 16Sakurabashi Watanabe Hospital, Osaka, 17Osaka National Hospital, Osaka, 18Okinawa Prefectural Chubu Hospital, Okinawa, 19Miyazaki Medical Association Hospital, Miyazaki and 20Hyogo College of Medicine, Hyogo, Japan. This study was supported by the Intramural Research Fund, grant number 23-4-5, for Cardiovascular Diseases of the National Cerebral and Cardiovascular Center. Address for correspondence: Kengo Tanabe, MD, Division of Cardiology, Mitsui Memorial Hospital, Kanda-Izumi-cho 1, Chiyoda-ku, Tokyo 101-8643, Japan. E-mail: kengo-t@zd5.so-net.ne.jp Received for publication January 6, 2017. Revised and accepted May 12, 2017. Released in advance online on J-STAGE February 20, 2018. doi: 10.1536/ihj.17-009 All rights reserved by the International Heart Journal Association.
Publisher Copyright:
© 2018, International Heart Journal Association. All rights reserved.
PY - 2018
Y1 - 2018
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.
KW - J-MINUET
UR - http://www.scopus.com/inward/record.url?scp=85044743732&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044743732&partnerID=8YFLogxK
U2 - 10.1536/ihj.17-009
DO - 10.1536/ihj.17-009
M3 - Article
C2 - 29459576
AN - SCOPUS:85044743732
SN - 1349-2365
VL - 59
SP - 263
EP - 271
JO - International Heart Journal
JF - International Heart Journal
IS - 2
ER -