Emergency Intensive Care Unit, Suining Central Hospital.
Cardiovascular Center, Suining Central Hospital.
Int Heart J. 2023 Nov 30;64(6):1010-1017. doi: 10.1536/ihj.23-383. Epub 2023 Nov 14.
This study aimed to investigate the relationship between blood urea nitrogen to albumin ratio (BAR) and the prognosis of heart failure (HF).A total of 2125 patients with HF were included in this single-center prospective cohort study between February 2012 and December 2017. Using a receiver operating characteristic curve, we determined the cutoff value of BAR as 0.24. All patients were divided into two groups according to the cutoff value of BAR.Among 2125 HF patients, the mean age was 56.7 ± 14.3. During a median follow-up time of 22 months, 516 end-point events occurred. Compared with patients in the low BAR group, those in the high BAR group were older; more likely to be male; had a higher percentage of hypertension, diabetes, smoking, and β-blocker use; and higher levels of alanine aminotransferase, glycosylated hemoglobin, creatinine, log-transformed NTproBNP, and Blood urea nitrogen but lower levels of albumin, triglycerides, high-density lipoprotein, ApoA1, and hemoglobin. Prognosis analysis indicated that high BAR was associated with increased mortality risk of HF (Hazard Ratio = 1.497, 95% CI = 1.234-1.816; P < 0.001) in the multivariate Cox proportional hazard regression model. Subgroup analysis revealed that stratification by age, gender, history of hypertension, diabetes, smoking, β-blocker use, and levels of hemoglobin, glycosylated hemoglobin, and creatinine have no obvious effect on the association between BAR ratio and the prognosis of HF. Furthermore, patients with high BAR represented a decreased left ventricular ejection fraction and increased left ventricular end-diastolic diameter.High BAR was an independent predictor for the mortality risk of HF.
本研究旨在探讨血尿素氮与白蛋白比值（BAR）与心力衰竭（HF）预后之间的关系。
这项单中心前瞻性队列研究纳入了 2012 年 2 月至 2017 年 12 月期间的 2125 例 HF 患者。通过接受者操作特征曲线，我们确定 BAR 的截断值为 0.24。所有患者均根据 BAR 的截断值分为两组。
在 2125 例 HF 患者中，平均年龄为 56.7 ± 14.3 岁。在中位随访时间为 22 个月期间，发生了 516 例终点事件。与 BAR 值较低的患者相比，BAR 值较高的患者年龄较大；更可能为男性；高血压、糖尿病、吸烟和β受体阻滞剂使用率较高；丙氨酸氨基转移酶、糖化血红蛋白、肌酐、对数转换 NTproBNP 和血尿素氮水平较高，但白蛋白、三酰甘油、高密度脂蛋白、载脂蛋白 A1 和血红蛋白水平较低。预后分析表明，BAR 值较高与 HF 死亡率风险增加相关（风险比=1.497，95%置信区间=1.234-1.816；P<0.001），这在多变量 Cox 比例风险回归模型中得到证实。亚组分析显示，按年龄、性别、高血压史、糖尿病史、吸烟史、β受体阻滞剂使用率以及血红蛋白、糖化血红蛋白和肌酐水平分层，BAR 比值与 HF 预后之间的关联无明显影响。此外，BAR 值较高的患者左心室射血分数降低，左心室舒张末期直径增大。BAR 值较高是 HF 死亡率的独立预测因子。
