Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
Hongisto, Mari
Lassus, Johan
Tarvasmäki, Tuukka
Sans-Roselló, Jordi (Institut d'Investigació Biomèdica Sant Pau)
Tolppanen, Heli
Kataja, Anu
Jäntti, Toni
Sabell, Tuija
Banaszewski, Marek
Silva-Cardoso, Jose
Parissis, John
Jurkko, Raija
Spinar, Jindrich
Castrén, Maaret
Mebazaa, Alexandre
Masip, Josep
Harjola, Veli-Pekka
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Soluble urokinase-type plasminogen activator receptor (suPAR) is a biomarker reflecting the level of immune activation. It has been shown to have prognostic value in acute coronary syndrome and heart failure as well as in critical illness. Considering the complex pathophysiology of cardiogenic shock (CS), we hypothesized suPAR might have prognostic properties in CS as well. The aim of this study was to assess the kinetics and prognostic utility of suPAR in CS. SuPAR levels were determined in serial plasma samples (0-96 h) from 161 CS patients in the prospective, observational, multicentre CardShock study. Kinetics of suPAR, its association with 90-day mortality, and additional value in risk-stratification were investigated. The median suPAR-level at baseline was 4. 4 [interquartile range (IQR) 3. 2-6. 6)] ng/mL. SuPAR levels above median were associated with underlying comorbidities, biomarkers reflecting renal and cardiac dysfunction, and higher 90-day mortality (49% vs. 31%; P = 0. 02). Serial measurements showed that survivors had significantly lower suPAR levels at all time points compared with nonsurvivors. For risk stratification, suPAR at 12 h (suPAR) with a cut-off of 4. 4 ng/mL was strongly associated with mortality independently of established risk factors in CS: OR 5. 6 (95% CI 2. 0-15. 5); P = 0. 001) for death by 90 days. Adding suPAR > 4. 4 ng/mL to the CardShock risk score improved discrimination identifying high-risk patients originally categorized in the intermediate-risk category. SuPAR associates with mortality and improves risk stratification independently of other previously known risk factors in CS patients.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cardiogenic shock ; Supar ; Risk stratification ; Biomarker
Published in:	European Heart Journal. Acute Cardiovascular Care, Vol. 11 (august 2022) , p. 731-738, ISSN 2048-8734

DOI: 10.1093/ehjacc/zuac096
PMID: 35949144

8 p, 435.5 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
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