An elevated blood urea nitrogen-to-serum albumin ratio at admission was independently associated with increased long-term all-cause mortality (HR 1.61) in patients with acute heart failure.
Cohort (n=2,556)
No
Does baseline blood urea nitrogen-to-serum albumin ratio (BAR) predict long-term mortality in patients with acute heart failure?
Elevated baseline blood urea nitrogen-to-serum albumin ratio (BAR) is an independent predictor of long-term all-cause mortality in patients with acute heart failure across all ejection fraction phenotypes.
Effect estimate: HR 1.61 (95% CI 1.43-1.72)
p-value: p=<0.001
Objectives The objective of this study was to evaluate the baseline blood urea nitrogen-to-serum albumin ratio (BAR) in patients with acute heart failure (AHF) upon admission as a predictor of long-term mortality. Methods In this retrospective cohort study, a total of 2,556 patients who were hospitalized for AHF at Beijing Anzhen Hospital between 2017 October and 2020 January were enrolled. Multivariate Cox regression analysis was performed to explore the association between BAR and out-of-hospital all-cause mortality. The risk stratification capability of BAR was also calculated using Kaplan–Meier survival analysis. Results Of the 2,556 patients with AHF, 1,196 had with heart failure with reduced ejection fraction, 1,066 had heart failure with preserved ejection fraction, and 294 had heart failure with mildly reduced ejection fraction. After a median follow-up of 1.84 years (IQR: 1.15, 2.57), 665 (26.0%) patients experienced out-of-hospital all-cause mortality. Univariate Cox regression analysis revealed that BAR was significantly associated with long-term mortality in all patients with AHF ( p 0.05). After adjusting for age, sex, and traditional clinical risk factors, BAR remained independently associated with mortality in both the overall population and each heart failure subgroup. Conclusion BAR was associated with long-term mortality in patients with AHF after discharge, regardless of left ventricular ejection fraction at admission. BAR exhibited risk stratification capacity for long-term mortality outcomes in patients with AHF.
Jia et al. (2026) conducted a cohort in Acute heart failure (n=2,556). Blood urea nitrogen-to-serum albumin ratio (BAR) was evaluated on Out-of-hospital all-cause mortality (HR 1.61, 95% CI 1.43-1.72, p=<0.001). An elevated blood urea nitrogen-to-serum albumin ratio at admission was independently associated with increased long-term all-cause mortality (HR 1.61) in patients with acute heart failure.