Serum blood urea nitrogen and plasma brain natriuretic Peptide and low diastolic blood pressure predict cardiovascular morbidity and mortality following discharge in acute decompensated heart failure patients.

Abstract

BACKGROUND:

 Patients with heart failure (HF) have a high risk of cardiovascular (CV) death and re-hospitalization. The purpose of the present study was therefore to investigate predictors of CV death and re-hospitalization for acute decompensated HF (ADHF).

METHODS AND RESULTS:

 A total of 225 patients aged 67.2±15.2 years, including 134 men (59.6%), who were hospitalized for ADHF between 2008 and 2009, were followed up. After discharge, the relationship between clinical parameters and CV events (ie, CV death or re-hospitalization for HF) was examined. Follow-up was continued until 30 April 2011. The most important predictors of re-hospitalization were serum blood urea nitrogen (BUN; adjusted hazard ratio [HR], 1.02; 95% confidence interval [CI]: 1.00-1.03, P=0.01), plasma brain natriuretic peptide (BNP; adjusted HR, 1.85; 95% CI: 1.12-3.04, P=0.02), and diastolic blood pressure (DBP; adjusted HR, 0.97; 95% CI: 0.94-1.00, P=0.049). The only predictor of CV mortality was a high BUN (adjusted HR, 1.05; 95% CI: 1.01-1.09, P=0.01).

CONCLUSIONS:

 High serum BUN (≥22.5mg/dl), high plasma BNP (≥250pg/ml), and low DBP (<60mmHg) predict CV events in patients hospitalized for ADHF. These factors may identify high-risk patients for CV events and provide therapeutic targets for managing HF.  (Circ J 2012; 76: 2372-2379).

• Authors: Chun-Yen Chen, Akemi Yoshida, Masanori Asakura, Takuya Hasegawa, Hiroyuki Takahama, Makoto Amaki, Akira Funada, Hiroshi Asanuma, Hiroyuki Yokoyama, Jiyoong Kim, Hideaki Kanzaki, Masafumi Kitakaze
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 76 Issue 10 Pg. 2372-9 ( 2012) ISSN: 1347-4820 [Electronic] Japan
• PMID: 22785557 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Natriuretic Peptide, Brain
• Urea
• Nitrogen

Topics

• Acute Disease
• Aged
• Aged, 80 and over
• Blood Pressure
• Female
• Heart Failure (blood, mortality, physiopathology)
• Humans
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Nitrogen (blood)
• Patient Discharge
• Urea (blood)