Journal Article

The role of cut-off values for creatinine, blood urea nitrogen, and uric acid in prognostic assessment of chronic heart failure: a retrospective cohort study

Dou, Liping, Xu, Manfei, Qian, Liyan, Yue, Yuebing, Xu, Zheng

2025

Overview

Background Chronic heart failure (CHF) significantly harms patients and society, causing high mortality and reduced quality of life, straining healthcare systems; early identification and intervention are crucial for improving long-term prognosis. Methods This retrospective cohort study involved 297 CHF patients. After collecting data on demographics, lab results, echocardiography, and comorbidities, ROC analysis was used to determine optimal cut-off values, followed by survival analysis and multivariate Cox regression to identify poor prognosis risk factors. Results ROC analysis set optimal cut-offs for Scr, BUN, and UA at 101.5 µmol/L, 8.61 mmol/L, and 462 µmol/L, with AUCs of 0.602 (Scr, UA) and 0.674 (BUN). Kaplan-Meier analysis showed significant curve separation, while Cox regression identified risk factors for poor prognosis: Scr ≥ 101.5 µmol/L (HR = 2.209, 95% CI 1.372–3.557, P  = 0.001), BUN ≥ 8.61 mmol/L (HR = 3.709, 95% CI 2.270–6.061, P  < 0.001), UA ≥ 462 µmol/L (HR = 2.625, 95% CI 1.631–4.228, P  < 0.001), male sex(HR = 1.764, 95% CI 1.067–2.915, P  = 0.027), hyperlipidemia (HR = 0.567, 95% CI 0.351–0.916, P  = 0.02), and re-hospitalization(HR = 0.480, 95% CI 0.280–0.826, P  = 0.008). Subgroup analysis indicates that male gender is a significant risk factor for females (OR:2.424, P  < 0.001); and age also posed a risk (OR:1.026, P  = 0.036). NYHA class IV had an OR of 0.42 compared to class III ( P  < 0.001), and class III had an OR of 0.307 compared to class II ( P  = 0.016). Patients without CHD had a 1.905-fold increased risk of poor prognosis ( P  = 0.033). Conclusion This study highlights key characteristics, assessment parameters, and risk factors for CHF patients, emphasizing the importance of Scr, BUN, and UA cut-off levels in management and guiding future research.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Aged, 80 and over / Analysis / Angiology / Atherosclerosis / Biological markers / Biomarkers / Biomarkers - blood / Blood Transfusion Medicine / Blood Urea Nitrogen / Brain natriuretic peptide / Cardiac function / Cardiac Surgery / Cardiology / Cardiomyopathy / Cardiorenal syndrome / Cardiovascular disease / Cholesterol / Chronic Disease / Chronic heart failure / Classification / Comorbidity / Congestive heart failure / Coronary heart disease / Correlation analysis / Creatinine / Creatinine - blood / Diabetes / Dosage and administration / Echocardiography / Ejection fraction / Female / Health aspects / Health care reform / Heart failure / Heart Failure - blood / Heart Failure - diagnosis / Heart Failure - mortality / Heart Failure - physiopathology / Heart Failure - therapy / High density lipoprotein / Humans / Hyperlipidemia / Hypertension / Internal Medicine / Liver / Long-term prognosis / Male / Medical prognosis / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Mortality / Patients / Predictive Value of Tests / Prevention / Primary healthcare / Prognosis / Quality of life / Regression analysis / Renal function / Retrospective Studies / Risk Assessment / Risk Factors / Software / Survival analysis / Taiwan / Time Factors / Urea / Uric acid / Uric Acid - blood