Association between Blood Urea Nitrogen Level and In-Hospital Mortality in Patients with Acute Myocardial Infarction and Subsequent Gastrointestinal Bleeding.

BACKGROUND

Limited studies have explored the association between blood urea nitrogen (BUN) levels and in-hospital mortality in patients with acute myocardial infarction (AMI) and subsequent gastrointestinal bleeding (GIB). Our objective was to explore this correlation.

METHODS

276 individuals with AMI and subsequent GIB were retrospectively included between January 2012 and April 2023. The predictive value of BUN for in-hospital mortality was assessed through receiver operating characteristic (ROC) curve. Logistic regression models were constructed to assess the relationship between BUN and in-hospital mortality. Propensity score weighting (PSW), sensitivity and subgroup analyses were used to further explore the association.

RESULTS

Fifty-three (19.2%) patients died in the hospital. BUN levels were higher in non-survivors compared with the survivors [(11.17 6.17) vs (8.09 4.24), = 0.001]. The ROC curve suggested that the optimal cut-off for BUN levels to predict in-hospital mortality was 8.45 mmol/L (AUC [area under the ROC curve] 0.678, 95% confidence interval [CI] 0.595-0.761, 0.001). Multivariable logistic regression showed that elevated BUN levels ( 8.45 mmol/L) were positively association with in-hospital mortality (odds ratio [OR] 4.01, 95% CI 1.55-10.42, = 0.004). After PSW, sensitivity and subgroup analyses, the association remained significant.

CONCLUSIONS

Elevated BUN levels were associated with in-hospital mortality in patients with AMI and subsequent GIB.