Background: Elevated blood urea nitrogen (BUN) has been shown to be closely related not only to renal dysfunction but also neurohumoral activation in heart failure (HF), and also reported to predict poor in-hospital and longterm outcomes in HF patients. In obese HF patients who have relatively lower BNP levels and higher neurohumoral activation, BUN may be greater significance. Methods and Results: We enrolled 53 overweight or obese patients with acute decompensated HF. (body mass index >25 kg/dL/m2 at discharge). They were divided into 2 groups according to BUN at discharge (groupL; BUN < 25 mg/dL n = 37, groupH; BUN >25 mg/dL n = 16). The composite endpoints were all cause death and re-hospitalization for HF were compared between the groups. GroupH had significantly higher older age, lower hemoglobin levels at discharge. During a median follow-up period of 438 ± 408 days after discharge, the Kaplan-Meier curve showed groupH had worse prognosis compared with groupL (Log-lank test P < .001) Multivariate analysis showed that BUN at discharge was a predictor of the composite endpoints. (hazard ratio, 1.25; 95% confidence interval, 1.03 to 1.52; P < .03) independent of other parameter of renal function. Conclusion: In overweight or obese patients with acute decompensated HF, BUN at discharge may be a useful predictor for adverse outcomes.
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