Abstract
Background Elevation of blood urea nitrogen (BUN) indicates renal dysfunction and is associated with increased mortality in cardiovascular diseases. We investigated the relationship between the BUN concentration measured at hospital admission and the long-term all-cause mortality in patients with stable angina pectoris (SAP).Methods The mortality rate of 344 patients who underwent coronary angiography (CAG) in our clinic due to SAP was analyzed during a mean follow-up period of 8 yrs.Results Age (p<0.001), male gender (p=0.020), waist circumference (p=0.007), body-mass index (p=0.002), fasting glucose (p=0.004), BUN (p<0.001), serum creatinine (Cr) (p<0.001), hemoglobin (p=0.015), triglyceride concentrations (p=0.033), and the Gensini score (p<0.001) were related to all-cause mortality as shown by univariate Cox regression analysis. Age (OR 1.056, 95 % CI 1.015-1.100, p=0.008), fasting glucose (OR 1.006, 95 % CI 1.001-1.011, p=0.018), BUN, (OR 1.077, 95 % CI 1.026-1.130, p=0.003), and the Gensini score (OR 2.269, 95 % CI 1.233-4.174, p=0.008) were significantly related with mortality as shown by multivariate Cox regression analysis. According to receiver operating characteristic analysis ofthe sensitivity and specificity of BUN and Cr for predicting mortality, the area under the curve values of BUN and Cr were 0.789 (p<0.001) and 0.652 (p=0.001), respectively. BUN had a stronger relationship with mortality than Cr. A concentration of BUN above 16.1 mg / dl had 90.1 % sensitivity and 60 % specificity for predicting mortality (OR=2.23).Conclusion In patients who underwent CAG due to SAP, the BUN concentration was associated with all-cause mortality during a mean follow-up period of 8 yrs.
Highlights
Urea is the primary metabolite derived from turnover of dietary and tissue protein
The mortality rate of 344 patients who underwent coronary angiography (CAG) in our clinic due to stable angina pectoris (SAP) was analyzed during a mean follow-up period of 8 yrs
The Blood urea nitrogen (BUN) concentration is an essential indicator of neuroendocrine activation in left ventricular dysfunction, unlike Cr and estimated glomerular filtration rate (eGFR), it does not have a strong relationship with renal function. [2,3,4,5] Elevation of the BUN concentration is an indicator of increased cardiovascular mortality during longterm follow-up, and it is associated with extremity ischemia and the extent of coronary artery disease (CAD) [7,8,9,10]
Summary
Urea is the primary metabolite derived from turnover of dietary and tissue protein. Blood urea nitrogen (BUN) is about one-half (0.446) of the blood urea. Increased renin-angiotensin system activation, sympathetic activity, and antidiuretic hormone increase the BUN concentration by its passive absorption from renal proximal tubules [2,3,4]. This increase may cause an elevation of BUN in heart failure patients [5]. The BUN concentration is an essential indicator of neuroendocrine activation in left ventricular dysfunction, unlike Cr and eGFR, it does not have a strong relationship with renal function.
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