Scholarlink

Background <p>To investigate the predictive value of the blood–urea–nitrogen/albumin ratio (BAR) for in-hospital major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) and to develop a risk prediction tool based on a multivariable model.</p> Methods <p>A retrospective cohort of 343 STEMI patients was enrolled and divided into MACE and non-MACE groups based on the occurrence of in-hospital MACE, defined as a composite of all-cause mortality, cardiogenic shock, malignant arrhythmia, and reinfarction. Differences in general characteristics and laboratory parameters were compared between groups. Univariate and multivariate logistic regression analyses identified independent predictors of in-hospital MACE, which were used to construct a nomogram model. Predictive performance was evaluated using Receiver Operating Characteristic (ROC) curves, and internal validation and calibration were evaluated using bootstrap resampling (1,000 iterations).</p> Results <p>Among 343 patients, 78 (22.7%) experienced in-hospital MACE. Compared with the non-MACE group, patients with MACE were older, had lower diastolic blood pressure, higher Killip class, lower left ventricular ejection fraction (LVEF), and higher BAR (all <i>P</i> &lt; 0.05). In multivariable analysis, Killip class (<i>OR</i> 1.902; 95% <i>CI</i> 1.385–2.611; <i>P</i> &lt; 0.001), LVEF (<i>OR</i> = 0.929, 95% <i>CI</i> 0.906–0.950; <i>P</i> &lt; 0.001), and BAR (<i>OR</i> = 2.097, 95% <i>CI</i> 1.628–2.763; <i>P</i> &lt; 0.001) were independent predictors of in-hospital MACE. BAR showed moderate discrimination for MACE (AUC = 0.695, 95% <i>CI</i> 0.628–0.763; <i>P</i> &lt; 0.001), with an optimal cutoff of 1.716 (sensitivity 79.5%, specificity 49.4%). The nomogram incorporating Killip class, LVEF, and BAR demonstrated good performance, with an apparent AUC of 0.819 and an optimism-corrected AUC of 0.813; calibration was satisfactory.</p> Conclusions <p>Elevated admission BAR is associated with a higher risk of in-hospital MACE in STEMI patients. A nomogram integrating Killip class, LVEF, and BAR may facilitate early in-hospital risk stratification as an adjunct to routine clinical assessment.</p> <p><i>Trial registration</i> This study was a retrospective observational analysis and did not involve any healthcare intervention in human participants.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Clinical value of blood–urea–nitrogen-to-albumin ratio in predicting in-hospital adverse outcomes among patients with STEMI

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月18日

查看全文
  • Minhua Kuang,
  • Jiajian Peng,
  • Qixin Yu,
  • Zhangrong Liang,
  • Qi Tang,
  • Mingfeng He

摘要

Background

To investigate the predictive value of the blood–urea–nitrogen/albumin ratio (BAR) for in-hospital major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) and to develop a risk prediction tool based on a multivariable model.

Methods

A retrospective cohort of 343 STEMI patients was enrolled and divided into MACE and non-MACE groups based on the occurrence of in-hospital MACE, defined as a composite of all-cause mortality, cardiogenic shock, malignant arrhythmia, and reinfarction. Differences in general characteristics and laboratory parameters were compared between groups. Univariate and multivariate logistic regression analyses identified independent predictors of in-hospital MACE, which were used to construct a nomogram model. Predictive performance was evaluated using Receiver Operating Characteristic (ROC) curves, and internal validation and calibration were evaluated using bootstrap resampling (1,000 iterations).

Results

Among 343 patients, 78 (22.7%) experienced in-hospital MACE. Compared with the non-MACE group, patients with MACE were older, had lower diastolic blood pressure, higher Killip class, lower left ventricular ejection fraction (LVEF), and higher BAR (all P < 0.05). In multivariable analysis, Killip class (OR 1.902; 95% CI 1.385–2.611; P < 0.001), LVEF (OR = 0.929, 95% CI 0.906–0.950; P < 0.001), and BAR (OR = 2.097, 95% CI 1.628–2.763; P < 0.001) were independent predictors of in-hospital MACE. BAR showed moderate discrimination for MACE (AUC = 0.695, 95% CI 0.628–0.763; P < 0.001), with an optimal cutoff of 1.716 (sensitivity 79.5%, specificity 49.4%). The nomogram incorporating Killip class, LVEF, and BAR demonstrated good performance, with an apparent AUC of 0.819 and an optimism-corrected AUC of 0.813; calibration was satisfactory.

Conclusions

Elevated admission BAR is associated with a higher risk of in-hospital MACE in STEMI patients. A nomogram integrating Killip class, LVEF, and BAR may facilitate early in-hospital risk stratification as an adjunct to routine clinical assessment.

Trial registration This study was a retrospective observational analysis and did not involve any healthcare intervention in human participants.