Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction
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Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction. / Sörensen, Nils A; Nikorowitsch, Julius; Neumann, Johannes T; Rübsamen, Nicole; Goßling, Alina; Hartikainen, Tau S; Blankenberg, Stefan; Westermann, Dirk; Zeller, Tanja; Karakas, Mahir.
In: CLIN RES CARDIOL, Vol. 108, No. 12, 12.2019, p. 1386-1393.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction
AU - Sörensen, Nils A
AU - Nikorowitsch, Julius
AU - Neumann, Johannes T
AU - Rübsamen, Nicole
AU - Goßling, Alina
AU - Hartikainen, Tau S
AU - Blankenberg, Stefan
AU - Westermann, Dirk
AU - Zeller, Tanja
AU - Karakas, Mahir
PY - 2019/12
Y1 - 2019/12
N2 - BACKGROUND: Early risk stratification of patients with suspected acute myocardial infarction (AMI) constitutes an unmet need in current daily clinical practice. We aimed to evaluate the predictive value of soluble urokinase-type plasminogen activator receptor (suPAR) levels for 1-year mortality in patients with suspected AMI.METHODS AND RESULTS: suPAR levels were determined in 1314 patients presenting to the emergency department with suspected AMI. Patients were followed up for 12 months to assess all-cause mortality. Of 1314 patients included, 308 were diagnosed with AMI. Median suPAR levels did not differ between subjects with AMI compared to non-AMI (3.5 ng/ml vs. 3.2 ng/ml, p = 0.066). suPAR levels reliably predicted all-cause mortality after 1 year. Hazard ratio for 1-year mortality was 12.6 (p < 0.001) in the quartile with the highest suPAR levels compared to the first quartile. The prognostic value for 6-month mortality was comparable to an established risk prediction model, the Global Registry of Acute Coronary Events (GRACE) score, with an AUC of 0.79 (95% CI 0.72-0.86) for the GRACE score and 0.77 (95% CI 0.69-0.84) for suPAR. Addition of suPAR improved the GRACE score, as shown by integrated discrimination improvement statistics of 0.036 (p = 0.03) suggesting a further discrimination of events from non-events by the addition of suPAR.CONCLUSIONS: suPAR levels reliably predicted mortality in patients with suspected AMI.STUDY REGISTRATION: http://www.clinicaltrials.gov (NCT02355457).
AB - BACKGROUND: Early risk stratification of patients with suspected acute myocardial infarction (AMI) constitutes an unmet need in current daily clinical practice. We aimed to evaluate the predictive value of soluble urokinase-type plasminogen activator receptor (suPAR) levels for 1-year mortality in patients with suspected AMI.METHODS AND RESULTS: suPAR levels were determined in 1314 patients presenting to the emergency department with suspected AMI. Patients were followed up for 12 months to assess all-cause mortality. Of 1314 patients included, 308 were diagnosed with AMI. Median suPAR levels did not differ between subjects with AMI compared to non-AMI (3.5 ng/ml vs. 3.2 ng/ml, p = 0.066). suPAR levels reliably predicted all-cause mortality after 1 year. Hazard ratio for 1-year mortality was 12.6 (p < 0.001) in the quartile with the highest suPAR levels compared to the first quartile. The prognostic value for 6-month mortality was comparable to an established risk prediction model, the Global Registry of Acute Coronary Events (GRACE) score, with an AUC of 0.79 (95% CI 0.72-0.86) for the GRACE score and 0.77 (95% CI 0.69-0.84) for suPAR. Addition of suPAR improved the GRACE score, as shown by integrated discrimination improvement statistics of 0.036 (p = 0.03) suggesting a further discrimination of events from non-events by the addition of suPAR.CONCLUSIONS: suPAR levels reliably predicted mortality in patients with suspected AMI.STUDY REGISTRATION: http://www.clinicaltrials.gov (NCT02355457).
KW - Aged
KW - Biomarkers/blood
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/blood
KW - Predictive Value of Tests
KW - Prognosis
KW - Receptors, Urokinase Plasminogen Activator/blood
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
U2 - 10.1007/s00392-019-01475-1
DO - 10.1007/s00392-019-01475-1
M3 - SCORING: Journal article
C2 - 30989318
VL - 108
SP - 1386
EP - 1393
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 12
ER -
