Objective: To further explore the relationship between the blood urea nitrogen to creatinine (BUN/Cr) ratio and the prognosis of patients with acute heart failure (AHF), a two-part study consisting of a prospective cohort study and meta-analysis were conducted. Methods: A total of 509 hospitalized patients with AHF were enrolled and followed up. Cox proportional hazards regression was used to analyze the relationship between the BUN/Cr ratio and the long-term prognosis of patients with AHF. Meta-analysis was also conducted regarding the topic by searching PubMed and Embase for relevant studies published up to October 2019. Results: During a median follow-up of 2.8 years, 197 (42.6%) deaths occurred. The cumulative survival rate of patients with a BUN/Cr ratio in the bottom quartile was significantly lower than in the other 3 groups (log-rank test: p = 0.003). In multivariate Cox regression models, the mortality rate of AHF patients with a BUN/Cr ratio in the bottom quartile was significantly higher than in the top quartile (adjusted HR 1.52; 95% CI 1.03–2.24). For the meta-analysis, we included 8 studies with 4,700 patients, consisting of 7 studies from the database and our cohort study. The pooled analysis showed that the highest BUN/Cr ratio category was associated with an 77% higher all-cause mortality than the lowest category (pooled HR 1.77; 95% CI 1.52–2.07). Conclusions: Elevated BUN/Cr ratio is associated with poor prognosis in patients with AFH and is an independent predictor of all-cause mortality.
Cardiorenal Med

中文翻译：

---

急性心力衰竭患者的血尿素氮与肌酐比和长期死亡率：一项前瞻性队列研究和荟萃分析

目的：为了进一步探讨血尿素氮与肌酐（BUN/Cr）比值与急性心力衰竭（AHF）患者预后的关系，进行了一项由前瞻性队列研究和荟萃分析组成的两部分研究。 . 方法：共纳入并随访509例AHF住院患者。采用Cox比例风险回归分析BUN/Cr比值与AHF患者远期预后的关系。通过在 PubMed 和 Embase 中搜索截至 2019 年 10 月发表的相关研究，还对该主题进行了元分析。结果：在中位随访 2.8 年期间，发生了 197 例（42.6%）死亡。BUN/Cr 比率在下四分位数的患者的累积生存率显着低于其他 3 组（对数秩检验：p = 0.003）。在多变量 Cox 回归模型中，BUN/Cr 比值位于底部四分位数的 AHF 患者的死亡率显着高于顶部四分位数（调整后的 HR 1.52；95% CI 1.03–2.24）。对于荟萃分析，我们纳入了 8 项研究，涉及 4,700 名患者，包括来自数据库和我们的队列研究的 7 项研究。汇总分析显示，最高 BUN/Cr 比率类别的全因死亡率比最低类别高 77%（汇总 HR 1.77；95% CI 1.52–2.07）。结论：BUN/Cr 比值升高与 AFH 患者的不良预后相关，并且是全因死亡率的独立预测因子。
心肾医学