Blood urea nitrogen-to-left ventricular ejection fraction ratio as a prognostic indicator in non-ST-elevation myocardial infarction: Clinical utility as a mortality marker
Heart and Lung, cilt.75, ss.171-177, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 75
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.hrtlng.2025.09.019
- Dergi Adı: Heart and Lung
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.171-177
- Anahtar Kelimeler: Blood urea nitrogen, Ventricular dysfunction, Non-ST elevated myocardial infarction, Myocardial infarction, Prognosis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Non-ST-elevation myocardial infarction (NSTEMI) accounts for the majority of acute coronary syndromes, and accurate early risk stratification is essential for guiding clinical management. Traditional scoring systems are complex and may not be feasible in emergency settings. The blood urea nitrogen-to-left ventricular ejection fraction ratio (BUN/LVEF) has recently been proposed as a simple biomarker reflecting the interaction between cardiac and renal function. Objectives: This study aimed to evaluate the prognostic value of BUN/LVEF in predicting 30-day all-cause mortality in patients with NSTEMI. Methods: We conducted a retrospective observational study including 222 patients diagnosed with NSTEMI who presented to the emergency department of a tertiary university hospital between April 2024 and April 2025. Demographic, clinical, laboratory, and echocardiographic data were collected from hospital records. BUN/LVEF was calculated as BUN (mg/dL)/LVEF (%). Receiver operating characteristic (ROC) analysis was used to assess predictive performance. Results: The median age was 61 years, and 70.3 % were male. The 30-day mortality rate was 13 %. Non-survivors had significantly higher BUN/LVEF compared with survivors (1.48 vs 0.64, p < 0.001). ROC analysis revealed that BUN/LVEF had an AUC of 0.802 for predicting mortality. A cutoff value of 1.465 provided 93.3 % sensitivity, 51.7 % specificity, and 87.8 % overall diagnostic accuracy. Conclusion: BUN/LVEF is a simple, accessible, and independent predictor of short-term mortality in NSTEMI patients. Its ease of calculation and strong prognostic performance suggest potential clinical utility as a rapid risk stratification tool in emergency practice.