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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1499093
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Background: The blood urea nitrogen (BUN) to albumin (ALB) ratio (BAR) is a novel biomarker that reflects both nutritional and inflammatory status and has been linked to the prognosis of various acute and chronic diseases. However, studies on its association with in-hospital prognosis in patients with non-ST-segment elevation myocardial infarction (NSTEMI) remain limited. Therefore, this study aimed to evaluate the relationship between BAR and in-hospital mortality in patients with NSTEMI.Methods: This study included 772 non-diabetic NSTEMI patients. The predictive performance was assessed using the area under the receiver operating characteristic (ROC) curve (AUC). Multivariable logistic regression was performed to identify the independent risk factors of in-hospital mortality.Subgroup analyses were conducted to evaluate the association between BAR and in-hospital mortality across different patient subgroups. Restricted cubic spline (RCS) function was applied to examine the nonlinear relationship between BAR and in-hospital mortality, and the two-piecewise logistic regression model was used for threshold effects analysis.Results: A total of 40 patients died during hospitalization. BAR exhibited strong predictive performance for in-hospital mortality (AUC = 0.83; 95% CI: 0.77-0.89) for in-hospital death.Multivariate analysis indicated that BAR was an independent risk factor for in-hospital mortality (OR = 1.06; 95% CI: 1.01-1.12), with a significant increase in mortality risk observed in most subgroups as BAR increased. A nonlinear relationship with a saturation effect was observed between BAR and in-hospital mortality (P for non-linearity = 0.002), with an inflection point of 8.51. Further two-piecewise logistic regression analysis revealed that when BAR was <8.51, the risk of in-hospital mortality increased significantly (OR = 1.69, 95% CI: 1.16-2.53), whereas when BAR was ≥8.51, the association was not statistically significant (OR = 0.99, 95% CI: 0.92-1.06).Conclusions: Baseline BAR serves as a simple, clinically useful prognostic biomarker of in-hospital mortality in patients with NSTEMI. Additionally, we identified a nonlinear relationship with saturation effect between BAR and in-hospital mortality.
Keywords: blood urea nitrogen to albumin ratio, bar, NSTEMI, nonlinear, Saturation effect, biomarker
Received: 24 Oct 2024; Accepted: 31 Mar 2025.
Copyright: © 2025 Yuan and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wensen Yao, Department of Geriatrics and Special medical treatment, The First Hospital of Jilin University, Changchun, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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