{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:11:55Z","timestamp":1785222715990,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To synthesize the existing evidence on the association of BCR with clinical outcomes in patients with heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive and systematic search of observational studies was conducted across five major databases\u2014PubMed, Embase, Scopus, Web of Science, and Google Scholar\u2014covering all records up to February 2024. The primary outcomes of interest included mortality, rehospitalization, cardiovascular events, and renal complications. To evaluate the methodological quality, the Newcastle\u2013Ottawa scale was applied, allowing for the structured assessment of bias across the selection, comparability, and outcome domains. Additionally, the certainty of the evidence was appraised using the GRADE framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty studies including 21\u2009397 HF patients were analyzed. For \u2265\u20091\u2010year mortality (11\u2009661 participants, 11 studies), hazard ratios ranged from 1.30 to 2.19, with the strongest association in HF with preserved ejection fraction (HR: 3.28, 95% CI: 2.00\u20135.38) with very low certainty. It also correlated with worse NYHA class IV versus II (MD: 12.03, 95% CI: 10.54\u201313.52) and increased risk of 1\u2010month major adverse cardiovascular events (OR: 2.47, 95% CI: 1.01\u20136.01), both with very low certainty. Most included cohort studies were rated as low risk of bias, with only two studies at moderate risk and one study at high risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated BCR is associated with adverse outcomes in patients with heart failure. However, its discriminative performance appears limited, and its incremental value over established biomarkers such as NT\u2010proBNP remains unclear. Further prospective studies are required to determine its clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70344","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:37:13Z","timestamp":1779694633000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinic Value of Blood Urea to Creatinine Ratio in Heart Failure Patients: A Systematic Review"],"prefix":"10.1002","volume":"49","author":[{"given":"Miguel","family":"Cabanillas\u2010Lazo","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n Neurociencias, Metabolismo, Efectividad Cl\u00ednica y Sanitaria (NEMECS) Universidad Cient\u00edfica del Sur Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger A.","family":"Sernaqu\u00e9\u2010Mechato","sequence":"additional","affiliation":[{"name":"Hospital Santa Rosa Lima Per\u00fa"},{"name":"Facultad de Medicina Humana, Universidad Continental Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Montes\u2010Baldarrago","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica de San Fernando Lima Per\u00fa"},{"name":"Facultad de Medicina de San Fernando Universidad Nacional Mayor de San Marcos Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeancarlo Velazco","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica de San Fernando Lima Per\u00fa"},{"name":"Facultad de Medicina de San Fernando Universidad Nacional Mayor de San Marcos Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria Loja","family":"Zapata","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica de San Fernando Lima Per\u00fa"},{"name":"Facultad de Medicina de San Fernando Universidad Nacional Mayor de San Marcos Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Alegre\u2010Cordero","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica de San Fernando Lima Per\u00fa"},{"name":"Facultad de Medicina de San Fernando Universidad Nacional Mayor de San Marcos Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0076-0985","authenticated-orcid":false,"given":"Carlos","family":"Quispe\u2010Vicu\u00f1a","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Neurociencias, Metabolismo, Efectividad Cl\u00ednica y Sanitaria (NEMECS) Universidad Cient\u00edfica del Sur Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3280-0024","authenticated-orcid":false,"given":"Frank","family":"Mayta\u2010Tovalino","sequence":"additional","affiliation":[{"name":"Vicerrectorado de Investigacion Universidad San Ignacio de Loyola Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.01.022"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac013"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010756"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2019.04.078"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjcn\/zvab073"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2017.01.008"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2346"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18115904"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1189884"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-17-0485"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-022-02692-9"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_13_14_1","unstructured":"G. A.Wells B.Shea D.O'Connell et al. The Newcastle\u2010Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta\u2010Analyses.2000 https:\/\/scholar.archive.org\/work\/zuw33wskgzf4bceqgi7opslsre\/access\/wayback\/www3.med.unipmn.it\/dispense_ebm\/2009-2010\/Corso%20Perfezionamento%20EBM_Faggiano\/NOS_oxford.pdf."},{"key":"e_1_2_13_15_1","unstructured":"J.Popay H.Roberts A.Sowden et al. Guidance on the Conduct of Narrative Synthesis in Systematic Reviews: A Product From the ESRC Methods Programme [Internet].2006 https:\/\/www.researchgate.net\/doi\/10.13140\/2.1.1018.4643."},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmed-2017-110668"},{"key":"e_1_2_13_17_1","unstructured":"H. J.Sch\u00fcnemann J.Bro\u017cek G. H.Guyatt andA. D.OxmanGRADE Handbook for Grading Quality of Evidence and Strength of Recommendations. 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