SPC365

What does the Ratio urea-to-creatinine in Heart Failure hospitalizations tell us?

Session: Sessão de Posters 21 - Insuficiência cardíaca aguda
Speaker: Simão Pedro Almeida Carvalho

Congress: CPC 2024
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 11. Acute Heart Failure
Subtheme: 11.6 Acute Heart Failure - Clinical
Session Type: Cartazes
FP Number: ---
Authors: Simão De Almeida Carvalho; Carlos Costa; Adriana Pacheco; Tiago Aguiar; Diana Carvalho; Andreia Fernandes; Mesquita Bastos; Ana Briosa

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="color:black">Introduction</span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Heart failure significantly affects morbidity and mortality, with each hospitalization posing risks for adverse outcomes. Identifying predictors of these outcomes shapes healthcare decisions, guiding hospitalization necessity and required care levels. Renal function is pivotal in bodily balance, intricately connected to cardiac function. Elevated urea levels, often linked to kidney disease and hypovolemia, signify various physiological contexts.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Objective</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To evaluate the influence of the urea-to-creatinine ratio upon admission on individuals admitted for decompensated heart failure.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">A cross-sectional study conducted at a single center, encompassing 619 hospitalized patients diagnosed with decompensated heart failure. Statistical analyses, such as Independent-Samples T Test and Chi-square, were performed utilizing SPSS.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results </strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">619 patients underwent assessment, averaging 79.4 years in age, with 40.9% being female. The average hospital stay duration was 4.1 days. Upon admission, the mean Nt-proBNP measured 8651 pg/mL. Within this cohort, 45.2% presented heart failure with reduced ejection fraction, featuring an average left ventricular ejection fraction of 43.1%.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">For two groups comparison we used a urea-to-creatinine ratio of 50, because that was the average in our sample, with the higher accuracy for the outcome analysis by ROC analysis. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">In the analysis there were relevant significant statistical differences between the group of patients with a urea-to-creatinine ratio less than 50 and higher. For the higher ratio group, the systolic blood and diastolic blood pressure at admission and hemoglobin were lower. In contrast an higher ratio was associated to incremental NT-proBNP and Systolic Pulmonary Artery Pressure (PSAP), estimated by transthoracic echocardiography. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Lastly, we conducted an outcomes analysis, for death, that showed statically significant differences, for an average higher urea-to-creatinine ratio in patients with increased death in the intra-hospitalar period, 30-days and within the total follow-up. In contrast the average value of urea-to-creatinine ratio showed a tendency to be higher in the group with an outcome of death at 1 year, but that difference as not statistically significant. </span></span></span></p>

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<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">In heart failure acute decompensation an higher urea-to-creatinine ratio was associated with other biomarkers of negative outcomes and directly associated with death after acute heart failure decompensation and hospitalization. &nbsp;</span></span></span>&nbsp;</p>