Yıl: 2021 Cilt: 28 Sayı: 10 Sayfa Aralığı: 1801 - 1806 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2020.09.1001 İndeks Tarihi: 17-01-2022

Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)

Öz:
Aim: Increased serum blood urea nitrogen (BUN) level is an indicator of neurohormonal and renal dysfunction, and is associated with the major adverse cardiovascular events (MACE). Chronic total occlusion (CTO) is a typical coronary artery disease diagnosed by coronary angiography. We established and tested the hypothesis that there might be a relationship between serum BUN level and long-term prognosis in patients with CTO. Materials and Methods: The study consisted of 124 patients diagnosed with CTO. The patients were followed up for a mean of 9.2 (7.4-9.5) years, and all-cause mortality was determined. Results: Patients were divided into two groups according to mortality outcome. During the follow-up, 38 of 124 patients died. Univariate Cox analysis showed that age (p=0.002), BUN (p=0.001), and serum creatinine levels (p=0.039) were associated with mortality. BUN level (OR: 1.074; 95% CI: 1.018-1.134; p=0.009) and age (OR: 1.043; 95% CI: 1.001-1.087, p=0.043) were independently associated with mortality in multivariate Cox analysis. In the ROC analysis, the AUC values for BUN and estimated glomerular filtration rate were 0.689 (p=0.002) and 0.650 (p=0.001), respectively. When the cutoff value for BUN level was considered >16 mg/ dL, the sensitivity was 68%, and the specificity was 53% (OR:1.38) to predict mortality. When the cutoff value was considered >20 mg/ dL, the sensitivity diminished to 40%, while the specificity increased to 90% (OR:3.9). Conclusion: In patients with CTO, BUN level is associated with increased all-cause mortality during long-term following. This relationship is independent of renal dysfunction.
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  • 1. Hosten AO. BUN and Creatinine. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations, 3rd edition. Boston: Butterworths; 1990. Chapter 193.
  • 2. Usberti M, Federico S, Di Minno G, et al. Effects of angiotensin II on plasma ADH, prostaglandin synthesis, and water excretion in normal humans. Am J Physiol 1985;248:254-9.
  • 3. Kato A, Klein JD, Zhang C, et al. Angiotensin II increases vasopressin-stimulated facilitated urea permeability in rat terminal IMCDs. Am J Physiol Renal Physiol 2000;279:835-40.
  • 4. Schrier R.W., Blood urea nitrogen and serum creatinine: not married in heart failure. Circ Heart Fail 2008;1:2-5.
  • 5. Testani JM, Cappola TP, Brensinger CP, et al. Interaction between loop diuretic-associated mortality and blood urea nitrogen concentration in chronic heart failure. J Am Coll Cardiol 2011;58:375-82.
  • 6. Jujo K, Mianami Y, Haruki S, et al. Persistent high blood urea nitrogen level is associated with increased risk of cardiovascular events in patients with acute heart failure. ESC Heart Fail 2017;4:545-53.
  • 7. Richter B, Sulzgruber P, Koller L, et al. Blood urea nitrogen has additive value beyond estimated glomerular filtration rate for prediction of long-term mortality in patients with acute myocardial infarction. Eur J Intern Med 2019;59:84-90.
  • 8. Rentrop KP, Cohen M, Blanke H, et al. Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J Am Coll Cardiol 1985;5:587-92.
  • 9. Kilian JG, Keech A, Adams MR, et al. Coronary collateralization: determinants of adequate distal vessel filling after arterial occlusion. Coron Artery Dis 2002;13:155-9.
  • 10. Cheitlin MD, Armstrong WF, Aurigemma GP, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). Circulation 2003;108:1146-62.
  • 11. Metkus TS, Suarez-Pierre A, Crawford TC, et al. Diastolic dysfunction is common and predicts outcome after cardiac surgery. J Cardiothorac Surg 2018;13:67.
  • 12. Hartupee J, Mann DL. Neurohormonal activation in heart failure with reduced ejection fraction. Nat Rev Cardiol. 2017:14:30-8.
  • 13. Rouleau JL, Moye LA, de Champlain J, et al. Activation of neurohumoral systems following acute myocardial infarction. Am J Cardiol 1991;68:80-6.
  • 14. Fefer P, Knudtson ML, Cheema AN, et al. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol 2012;59:991-7.
  • 15. Rathore S, Matsuo H, Terashima M, et al. Procedural and in-hospital outcomes after percutaneous coronary intervention for chronic total occlusions of coronary arteries 2002 to 2008: impact of novel guidewire techniques. JACC Cardiovasc Interv 2009;2:489-97.
  • 16. Pagley PR, Beller GA, Watson DD, et al. Improved outcome after coronary bypass surgery in patients with ischemic cardiomyopathy and residual myocardial viability. Circulation 1997:96:793-800.
  • 17. Varma N, Morgan JP, Apstein CS. Mechanisms underlying ischemic diastolic dysfunction: relation between rigor, calcium homeostasis, and relaxation rate. Am J Physiol Heart Circ Physiol 2003;284:758- 71.
  • 18. Huang R, Song X, Zhang H, et al. The success of opening single chronic total occlusion lesions to improve myocardialviabilitytrial (SOS-COMEDY): Study protocol of a prospective multicenter study. Medicine (Baltimore) 2018;97:e0443.
  • 19. Shah A. Chronic Total Occlusion Coronary Intervention: In Search of a Definitive Benefit. Methodist Debakey Cardiovasc J 2018;14:50-9.
  • 20. Horiuchi Y, Aoki J, Tanabe K, et al. A High Level of Blood Urea Nitrogen Is a Significant Predictor for Inhospital Mortality in Patients with Acute Myocardial Infarction. Int Heart J 2018;59:263-71.
  • 21. Zhou J, Cui X, Jin X, et al. Association of renal biochemical parameters with left ventricular diastolic dysfunction in a community-based elderly population in China: a cross-sectional study. PLoS One 2014;9:e88638.
  • 22. Otsuka T, Suzuki M, Yoshikawa H, et al. Left ventricular diastolic dysfunction in the early stage of chronic kidney disease. J Cardiol 2009;54:199-204.
  • 23. Ren X, Qu W, Zhang L, et al. Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure. Sci Rep 2018;8:13507.
  • 24. Metra M, Cotter G, Gheorghiade M, et al. The role of the kidney in heart failure. Eur Heart J 2012;33:2135-42.
  • 25. Anavekar NS, McMurray JJ, Velazquez EJ, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med 2004;351:1285-95.
  • 26. Thakar CV, Worley S, Arrigain S, et al. Influence of renal dysfunction on mortality after cardiac surgery: modifying effect of preoperative renal function. Kidney Int 2005;67:1112-9.
APA Özyıldız A, Çetin M, OZER S, duman h, KIRIŞ T (2021). Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). , 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
Chicago Özyıldız Ali Gökhan,Çetin Mustafa,OZER SAVAS,duman hakan,KIRIŞ TUNCAY Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). (2021): 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
MLA Özyıldız Ali Gökhan,Çetin Mustafa,OZER SAVAS,duman hakan,KIRIŞ TUNCAY Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). , 2021, ss.1801 - 1806. 10.5455/annalsmedres.2020.09.1001
AMA Özyıldız A,Çetin M,OZER S,duman h,KIRIŞ T Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). . 2021; 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
Vancouver Özyıldız A,Çetin M,OZER S,duman h,KIRIŞ T Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). . 2021; 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
IEEE Özyıldız A,Çetin M,OZER S,duman h,KIRIŞ T "Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)." , ss.1801 - 1806, 2021. 10.5455/annalsmedres.2020.09.1001
ISNAD Özyıldız, Ali Gökhan vd. "Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)". (2021), 1801-1806. https://doi.org/10.5455/annalsmedres.2020.09.1001
APA Özyıldız A, Çetin M, OZER S, duman h, KIRIŞ T (2021). Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). Annals of Medical Research, 28(10), 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
Chicago Özyıldız Ali Gökhan,Çetin Mustafa,OZER SAVAS,duman hakan,KIRIŞ TUNCAY Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). Annals of Medical Research 28, no.10 (2021): 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
MLA Özyıldız Ali Gökhan,Çetin Mustafa,OZER SAVAS,duman hakan,KIRIŞ TUNCAY Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). Annals of Medical Research, vol.28, no.10, 2021, ss.1801 - 1806. 10.5455/annalsmedres.2020.09.1001
AMA Özyıldız A,Çetin M,OZER S,duman h,KIRIŞ T Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). Annals of Medical Research. 2021; 28(10): 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
Vancouver Özyıldız A,Çetin M,OZER S,duman h,KIRIŞ T Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results). Annals of Medical Research. 2021; 28(10): 1801 - 1806. 10.5455/annalsmedres.2020.09.1001
IEEE Özyıldız A,Çetin M,OZER S,duman h,KIRIŞ T "Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)." Annals of Medical Research, 28, ss.1801 - 1806, 2021. 10.5455/annalsmedres.2020.09.1001
ISNAD Özyıldız, Ali Gökhan vd. "Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)". Annals of Medical Research 28/10 (2021), 1801-1806. https://doi.org/10.5455/annalsmedres.2020.09.1001