Urea Nitrogen-to-Albumin Ratio Predicts Ventricular Aneurysm Formation in ST-Segment Elevation Myocardial Infarction
Authors' conclusion
A higher BAR was an independent predictor for LVA formation in STEMI patients with primary PCI.
Study context
- Population
- STEMI patients undergoing primary percutaneous coronary intervention (PCI)
- Participants
- 1,123 patients
- Exposure
- Left ventricular aneurysm (LVA) vs non-LVA
- LVAn = 162
- Outcome
- Predictive value of blood urea nitrogen-to-albumin ratio (BAR) for LV aneurysm formation
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
BAR as predictor of LVA formation
LVA
0.16
range or IQR (as printed) 0.13–0.19
non-LVA
0.13
range or IQR (as printed) 0.10–0.17
P < 0.001
- BAR independent predictor of LVA (multivariable logistic regression), OR
- 2.208, P = 0.018
- Left ventricular ejection fraction (LVEF) independent predictor, OR
- 0.865, P < 0.001
- Culprit vessel LAD independent predictor, OR
- 4.705, P < 0.001
- BAR discriminant power (C statistic) for LVA
- 0.723
Observational data: associations, not effects.
Further findings
Cross-validation of BAR
- Training set OR
- 1.957, P = 0.034
- Validation set OR
- 1.982, P = 0.039
LVA maximal length and width, BAR ≥ 0.15 vs BAR < 0.15
- Maximal length
- 3.37 ± 1.09 vs. 2.92 ± 0.93, P = 0.01
- Maximal width
- 2.20 ± 0.55 vs. 1.85 ± 0.63, P = 0.001
Discrimination for LVA (C statistic)
- Blood urea nitrogen (inferior to BAR)
- 0.586, P < 0.001
- Albumin (inferior to BAR)
- 0.64, P < 0.001
- BAR + LVEF + culprit vessel LAD (vs BAR)
- 0.874, P < 0.001
Subgroups (age, sex, hypertension, DM, smoking, LVEF, serum albumin, multivessel disease, Gensini score)
- No effect on association between BAR and LVA risk
- P < 0.05 for all subgroups
Original publication
Urea Nitrogen-to-Albumin Ratio Predicts Ventricular Aneurysm Formation in ST-Segment Elevation Myocardial Infarction. ESC Heart Fail. Published 17 January 2024. doi:10.
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