所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||Persistent High Blood Urea Nitrogen Level is Associated with Increased Cardiovascular Mortality in Acute Heart Failure Patients|
|発表者・共同発表者||◎重城健太郎, 南雄一郎, 春木伸太郎, 嵐弘之, 嶋崎健介, 門脇拓, 関口治樹, 萩原誠久|
|学会抄録||PROGRAM JCS 2017 346|
|概要||Background: The association between blood urea nitrogen (BUN) level at discharge and cardiovascular outcomes in patients with acutely decompensated congestive heart failure (HF) is unclear.
Methods and Results: We initially recruited 403 consecutive patients who were urgently hospitalized due to acutely decompensated HF without regular hemodialysis. After excluding patients who died in hospital, 353 patients were divided into 4 subgroups depending on their BUN level at admission and discharge, using a cut‒off level of 21.0 mg/dL. Among 206 patients with high baseline BUN level, 46 (22%) and 160 (78%) had normal and persistent high‒BUN levels at discharge, respectively. In contrast, of the 147 patients with normal baseline BUN level, 55 (37%) and 92 (63%) had high and normal BUN levels at discharge, respectively. During 298 days of median follow‒up after discharge, Kaplan‒Meier analysis showed the highest rate of cardiovascular mortality in patients with persistent high‒BUN (2‒year rate: 24%, Log‒rank test: p=0.009). Interestingly, patients with normalized BUN levels achieved similar outcomes to those with normal baseline BUN levels. Among patients with high baseline BUN levels, logistic regression analysis revealed that high BUN and low hemoglobin on admission were independent predictors for persistent high‒BUN levels.
Conclusion: Persistent high BUN levels are associated with an increased risk of cardiovascular mortality. Normalization of BUN levels during hospitalization may improve long‒term clinical outcomes.