Duan Siyu, Li Yuqi, Yang Ping
Second Clinical Medical School, Medical University of Kunming, Kunming, China.
School of Basic Medicine, Medical University of Kunming, Kunming, China.
Front Cardiovasc Med. 2023 Jul 31;10:1189884. doi: 10.3389/fcvm.2023.1189884. eCollection 2023.
The mortality rate of patients with heart failure (HF) remains high, and when heart failure occurs, blood urea nitrogen (BUN) is involved in the perfusion of renal blood flow. Some studies have shown an association between heart failure prognosis and blood urea nitrogen, but the results of some other studies were inconsistent. Therefore, we conducted a comprehensive meta-analysis to investigate the value of BUN on the prognosis of patients with heart failure.
A computerized systematic search of all English literature was performed in four databases, PubMed, Cochrane, Embase and Web of Science, from their inception to May 2022. The data of BUN were classified into continuous and categorical variables after passing the inclusion and exclusion criteria. The BUN data of both types were extracted separately into stata15.0 for statistical analysis.
A total of 19 cohort studies involving 56,003 patients were included. When BUN was used as a categorical variable, the risk of death in heart failure was 2.29 times higher for high levels of BUN than for low levels of BUN ( = 2.29, 95% CI:1.42-3.70, < 0.001). The results showed statistical significance in multifactorial and univariate groups, the prospective cohort, and European and Asian groups. When BUN was used as a continuous variable, the risk of death in heart failure was 1.02 times higher for each unit increase in BUN ( = 1.02, 95% CI:1.01-1.03, < 0.001). Subgroup analysis showed statistical significance in retrospective cohort, American and Asian.
High BUN is an independent predictor of all-cause mortality in heart failure. Lower BUN was associated with better prognosis in patients with heart failure.
心力衰竭（HF）患者的死亡率仍然很高，心力衰竭发生时，血尿素氮（BUN）参与肾血流灌注。一些研究表明心力衰竭预后与血尿素氮之间存在关联，但其他一些研究结果并不一致。因此，我们进行了一项全面的荟萃分析，以研究血尿素氮对心力衰竭患者预后的价值。
对PubMed、Cochrane、Embase和Web of Science这四个数据库从创建到2022年5月的所有英文文献进行计算机系统检索。血尿素氮数据在通过纳入和排除标准后分为连续变量和分类变量。将这两种类型的血尿素氮数据分别提取到stata15.0中进行统计分析。
共纳入19项队列研究，涉及56003例患者。当将血尿素氮作为分类变量时，血尿素氮高水平组心力衰竭患者的死亡风险是低水平组的2.29倍（=2.29，95%CI：1.42-3.70，<0.001）。结果在多因素和单因素组、前瞻性队列以及欧洲和亚洲组中显示出统计学意义。当将血尿素氮作为连续变量时，血尿素氮每增加一个单位，心力衰竭患者的死亡风险就会增加1.02倍（=1.02，95%CI：1.01-1.03，<0.001）。亚组分析在回顾性队列、美国和亚洲组中显示出统计学意义。
高血尿素氮是心力衰竭全因死亡率的独立预测因素。较低的血尿素氮与心力衰竭患者较好的预后相关。
