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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 < 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).
SUBMITTER: Sorensen NA
PROVIDER: S-EPMC6867986 | biostudies-literature | 2019 Dec
REPOSITORIES: biostudies-literature
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]