Blood urea nitrogen-to-serum albumin ratio as a predictor of long-term mortality in patients with acute heart failure.

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 ( 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.