PMID- 32160250
OWN - NLM
STAT- MEDLINE
DCOM- 20200622
LR  - 20200622
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 15
IP  - 3
DP  - 2020
TI  - Urea level is an independent predictor of mortality in patients with severe 
      aortic valve stenosis.
PG  - e0230002
LID - 10.1371/journal.pone.0230002 [doi]
LID - e0230002
AB  - INTRODUCTION: Severe aortic stenosis (AS) is the most common valvular heart 
      disease in the western world. Various factors are related to severe AS prognosis, 
      including chronic kidney disease. The aim of this study was to evaluate the 
      prognostic value of urea level in patients with severe AS. METHODS: We 
      prospectively enrolled 142 patients (79.1+/-9.4 years, 88 women) with severe AS 
      (mean valve area 0.67+/- 0.17 cm2). Clinical assessment, blood tests and 
      echocardiography were performed at enrollment and follow up. The patient 
      population was divided into low and high urea level groups, according to the 
      median urea level at enrollment (72 patients, mean urea 35.5+/-6.2 mg/dL and 70 
      patients, mean urea 61.1+/-17.8 mg/dL, respectively). Hundred and twelve patients 
      (79%) underwent aortic valve intervention. The primary endpoint was all-cause and 
      cardiovascular mortality. OUTCOMES: During follow-up of 37+/-19.5 months, 56 
      (37.1%) patients died, 39 due to cardiovascular causes. In univariate analysis, 
      age, urea level, creatinine, New York Heart Association (NYHA) class and aortic 
      valve intervention were associated with all-cause mortality. However, in 
      multivariate analysis only aortic valve intervention and blood urea were 
      independent predictors of all-cause mortality (HR 0.494; 95% CI 0.226-0.918, P = 
      0.026 and HR 1.015; 95% CI 1.003-1.029, P = 0.046 respectively). Urea level, NYHA 
      class and age were also significant predictors of cardiovascular mortality. 
      Whereas, in multivariate analysis, only urea level predicted cardiovascular 
      mortality in these patients (HR 1.017; CI 1.003-1.031 P = 0.019). CONCLUSIONS: 
      Blood urea, a generally readily available and routinely determined marker of 
      renal function, is an independent prognostic factor in patients with severe AS.
FAU - Haberman, Dan
AU  - Haberman D
AUID- ORCID: 0000-0003-2897-8919
AD  - The Heart Institute, Kaplan Medical Center, Rehovot, Israel.
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
FAU - Chernin, Gil
AU  - Chernin G
AD  - Nephrology Department Kaplan Medical Center, Rehovot, Israel.
AD  - Heart Institute, Hadassah Medical Center, Jerusalem, Israel.
FAU - Meledin, Valery
AU  - Meledin V
AD  - The Heart Institute, Kaplan Medical Center, Rehovot, Israel.
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
FAU - Zikry, Meital
AU  - Zikry M
AD  - The Heart Institute, Kaplan Medical Center, Rehovot, Israel.
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
FAU - Shuvy, Mony
AU  - Shuvy M
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
AD  - Heart Institute, Hadassah Medical Center, Jerusalem, Israel.
FAU - Gandelman, Gera
AU  - Gandelman G
AD  - The Heart Institute, Kaplan Medical Center, Rehovot, Israel.
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
FAU - Goland, Sorel
AU  - Goland S
AD  - The Heart Institute, Kaplan Medical Center, Rehovot, Israel.
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
FAU - George, Jacob
AU  - George J
AD  - The Heart Institute, Kaplan Medical Center, Rehovot, Israel.
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
FAU - Shimoni, Sara
AU  - Shimoni S
AD  - The Heart Institute, Kaplan Medical Center, Rehovot, Israel.
AD  - Hebrew University and Hadassah Medical School, Jerusalem, Israel.
LA  - eng
PT  - Journal Article
DEP - 20200311
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 8W8T17847W (Urea)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/pathology
MH  - Aortic Valve Stenosis/complications/*pathology
MH  - Cardiovascular Diseases/complications/*mortality/pathology
MH  - Disease-Free Survival
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Urea/*blood
PMC - PMC7065786
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/03/12 06:00
MHDA- 2020/06/23 06:00
PMCR- 2020/03/11
CRDT- 2020/03/12 06:00
PHST- 2019/11/10 00:00 [received]
PHST- 2020/02/19 00:00 [accepted]
PHST- 2020/03/12 06:00 [entrez]
PHST- 2020/03/12 06:00 [pubmed]
PHST- 2020/06/23 06:00 [medline]
PHST- 2020/03/11 00:00 [pmc-release]
AID - PONE-D-19-31304 [pii]
AID - 10.1371/journal.pone.0230002 [doi]
PST - epublish
SO  - PLoS One. 2020 Mar 11;15(3):e0230002. doi: 10.1371/journal.pone.0230002. 
      eCollection 2020.