The effect of serum BUN level on hospital mortality of patients with ST-segment elevation myocardial infarction undergone primary angioplasty

Abstract

Ischemic heart disease is the most common cardiovascular disease in the world and is the most important cause of death. Kidney dysfunction is associated with increased mortality in acute coronary syndrome and other cardiovascular diseases. The prognostic value of renal dysfunction was assessed using creatinine-based kidney tests. Few data are available on the prognostic significance of blood urea nitrogen (BUN) in patients with acute coronary syndrome. We aimed to assess the effect of serum BUN level on mortality and complications of patients with ST-segment elevation myocardial infarction undergone primary angioplasty, in this study. Materials and Methods: In this cross-sectional study, 240 patients referred to Shahid-Madani Cardiovascular Hospital in Tabriz who were diagnosed with STEMI and undergone primary angioplasty between 2013 and 2017 were selected. Information on demographic criteria, risk factors, vital signs, electrocardiogram findings, echocardiographic criteria, laboratory tests, total ischemic time, patient drug history, angiographic criteria, hospital mortality, 6-month mortality and nosocomial complications were evaluated and compared in two groups of patients with BUN greater than 25 mg/dl and patients with BUN less than 25 mg/dl. Results: From 240 patients studied, 211 patients (87.9%) had BUN≤25 mg/dl and 29 patients (12.1%) had BUN>25 mg/dl, the frequency of women was significantly higher in patients with high level BUN (p=0.003) and these patients were significantly older than others (p=0.001). Unfavorable laboratory findings such as anemia, leukocytosis, high creatinine, hyponatremia, hyperkalemia and hypertension occurred significantly more in patients with a BUN above 25 mg/dl. Also, rate of tachycardia was significantly higher in the above patients (p=0.022) and these patients had significantly left ventricular dysfunction (p=0.006). Overall, nosocomial complications (10.3% vs. 0.5%) and 6-month mortality (6.9% vs. 0.9%) were significantly higher in patients with BUN above 25 mg/dl, however, despite the high percentage of hospital mortality in the above patients, there was no significant difference.