Heart failure & cardiomyopathiesMeta-analysis
Independent Prognostic Importance of Blood Urea Nitrogen to Creatinine Ratio in Heart Failure
- Pooled individual patient data analysis of randomised trials
- HFrEF: PARADIGM-HF, ATMOSPHERE, DAPA-HF
- HFpEF: PARAGON-HF, I-PRESERVE
Authors' conclusion
Higher BUN/creatinine ratio was associated with worse outcomes in patients with chronic HF across the spectrum of left ventricular ejection fraction, independently of eGFR and NT-proBNP.
Study context
- Population
- Patients with chronic heart failure (HF) (HFrEF and HFpEF) in clinical trialsanalysed
- Participants
- 28,820 patients
- Comparison
- Blood urea nitrogen (BUN)/creatinine ratio >median vs ≤median, within HFrEF and HFpEF
- Outcome
- Composite of:
- Time to first HF hospitalization
- CV death
Pooled result
As reported in the abstract
HF hospitalization or CV death, its components and all-cause death
- Risk of each outcome significantly higher with BUN/creatinine ratio ≥median vs <median, even after adjustment incl. NT-proBNP and estimated glomerular filtration rate (eGFR)
Further pooled results
Median
| Outcome | HFpEF | HFrEF |
|---|---|---|
| BUN/creatinine ratio | 20.1 (IQR 16.7–24.7) | 18.7 (IQR 15.2–22.8) |
Baseline correlates of higher BUN/creatinine ratio
- Associated with older age, female sex and DM, but similar eGFR, in both HFpEF and HFrEF
Original publication
Independent Prognostic Importance of Blood Urea Nitrogen to Creatinine Ratio in Heart Failure. Eur J Heart Fail. Published 15 January 2024. doi:10.1002/ejhf.3114
Summarised from the published abstract; every number is checked against it