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Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction.

ABSTRACT: 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?

SUBMITTER: Sorensen NA

PROVIDER: S-EPMC6867986 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction.

Sörensen Nils A NA Nikorowitsch Julius J Neumann Johannes T JT Rübsamen Nicole N Goßling Alina A Hartikainen Tau S TS Blankenberg Stefan S Westermann Dirk D Zeller Tanja T Karakas Mahir M

Clinical research in cardiology : official journal of the German Cardiac Society 20190416 12

<h4>Background</h4>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.<h4>Methods and results</h4>suPAR levels were determined in 1314 patients presenting to the emergency department with suspected AMI. Patients were followed up for 12 ...[more]

PMID: 30989318

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Project description:BACKGROUND AND OBJECTIVES:Black Americans with and without APOL1 kidney disease risk variants face high risk of ESKD. Soluble urokinase-type plasminogen activator receptor (suPAR), a circulating signaling protein and marker of immune activation, constitutes a promising biomarker of CKD-associated risks. We aimed to quantify the associations between serum suPAR concentration and adverse outcomes in Black Americans with and without APOL1 kidney disease risk variants, over and above iodine-125 iothalamate measured GFR and proteinuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:Using data from the African-American Study of Kidney Disease and Hypertension, a multicenter clinical trial followed by a cohort phase with a median total follow-up of 9.7 years (interquartile range, 6.5-10.9 years), we examined the associations of suPAR with CKD progression (defined as doubling of serum creatinine or ESKD), ESKD, worsening proteinuria (defined as pre-ESKD doubling of 24-hour urine protein-to-creatinine ratio to ?220 mg/g), and all-cause death. RESULTS:At baseline, the median suPAR was 4462 pg/ml, mean measured GFR was 46 ml/min per 1.73 m2, and median 24-hour urine protein-to-creatinine ratio was 80 mg/g. After controlling for baseline demographics, randomization arm, GFR, proteinuria, APOL1 risk status, and clinical risk factors, there was a 1.26-times higher risk for CKD progression per SD higher baseline log-transformed suPAR (hazard ratio [HR], 1.26; 95% confidence interval [95% CI], 1.11 to 1.43; P<0.001). Higher suPAR was also independently associated with risk of ESKD (HR, 1.36; 95% CI, 1.17 to 1.58; P<0.001) and death (HR, 1.25; 95% CI, 1.08 to 1.45; P=0.003). suPAR was only associated with worsening proteinuria in patients with two APOLI risk alleles (HR, 1.46; 95% CI, 1.08 to 1.99; P=0.02). CONCLUSIONS:Higher suPAR was associated with various adverse outcomes in Black Americans with CKD, with and without APOL1 kidney disease risk variants, independently of proteinuria and GFR.

Dataset Information

Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction.

Publications

Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction.

Similar Datasets

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