TY - JOUR
T1 - Soluble urokinase receptor as a predictor of non-cardiac mortality in patients with percutaneous coronary intervention treated ST-segment elevation myocardial infarction
AU - Sandø, Andreas
AU - Schultz, Martin
AU - Eugen-Olsen, Jesper
AU - Køber, Lars
AU - Engstrøm, Thomas
AU - Kelbæk, Henning
AU - Jørgensen, Erik
AU - Saunamäki, Kari
AU - Holmvang, Lene
AU - Pedersen, Frants
AU - Tilsted, Hans Henrik
AU - Høfsten, Dan
AU - Helqvist, Steffen
AU - Clemmensen, Peter
AU - Iversen, Kasper
PY - 2020/6
Y1 - 2020/6
N2 - BACKGROUND: Identification of patients at high risk of non-cardiac mortality following ST-segment elevation myocardial infarction (STEMI) could guide clinicians to identify patients who require attention due to serious non-cardiac conditions after the acute phase of STEMI. The purpose of this study was to evaluate if the non-specific and prognostic biomarker of inflammation and comorbidity, soluble urokinase receptor (suPAR), could predict non-cardiac mortality in a cohort of STEMI patients.METHODS: SuPAR was measured in 1,190 STEMI patients who underwent primary percutaneous coronary intervention (pPCI). The primary endpoint was non-cardiac mortality, secondary endpoints were cardiac mortality, all-cause mortality, reinfarction and periprocedural acute kidney injury. Backwards elimination of potential confounders significantly associated with the respective outcome was used to adjust associations.RESULTS: Patients were followed for a median of 3.0 years (interquartile range 2.5 to 3.6 years). Multivariate cox regression revealed that a plasma suPAR level above 3.70 ng mL-1 was associated with non-cardiac and cardiac mortality at hazard ratios 3.33 (95 % confidence interval 1.67-6.63, p = 0.001, adjusted for age) and 0.99 (0.18-5.30, p = 0.98, adjusted for previous myocardial infarction and left ventricular ejection fraction), respectively.CONCLUSION: In patients with pPCI treated STEMI, suPAR was an independent prognostic biomarker of non-cardiac but not cardiac mortality and may identify patients with high risk of non-cardiac mortality.
AB - BACKGROUND: Identification of patients at high risk of non-cardiac mortality following ST-segment elevation myocardial infarction (STEMI) could guide clinicians to identify patients who require attention due to serious non-cardiac conditions after the acute phase of STEMI. The purpose of this study was to evaluate if the non-specific and prognostic biomarker of inflammation and comorbidity, soluble urokinase receptor (suPAR), could predict non-cardiac mortality in a cohort of STEMI patients.METHODS: SuPAR was measured in 1,190 STEMI patients who underwent primary percutaneous coronary intervention (pPCI). The primary endpoint was non-cardiac mortality, secondary endpoints were cardiac mortality, all-cause mortality, reinfarction and periprocedural acute kidney injury. Backwards elimination of potential confounders significantly associated with the respective outcome was used to adjust associations.RESULTS: Patients were followed for a median of 3.0 years (interquartile range 2.5 to 3.6 years). Multivariate cox regression revealed that a plasma suPAR level above 3.70 ng mL-1 was associated with non-cardiac and cardiac mortality at hazard ratios 3.33 (95 % confidence interval 1.67-6.63, p = 0.001, adjusted for age) and 0.99 (0.18-5.30, p = 0.98, adjusted for previous myocardial infarction and left ventricular ejection fraction), respectively.CONCLUSION: In patients with pPCI treated STEMI, suPAR was an independent prognostic biomarker of non-cardiac but not cardiac mortality and may identify patients with high risk of non-cardiac mortality.
KW - Acute coronary syndrome
KW - Biomarker
KW - Low-grade inflammation
KW - suPAR
UR - http://www.scopus.com/inward/record.url?scp=85082548188&partnerID=8YFLogxK
U2 - 10.1016/j.clinbiochem.2020.03.013
DO - 10.1016/j.clinbiochem.2020.03.013
M3 - Journal article
C2 - 32213303
SN - 0009-9120
VL - 80
SP - 8
EP - 13
JO - Clinical Biochemistry
JF - Clinical Biochemistry
ER -