suPAR Predicts Non-Cardiac Mortality After Primary PCI for STEMI
In 1,190 STEMI patients who underwent primary percutaneous coronary intervention, plasma suPAR above 3.70 ng/mL was an independent predictor of non-cardiac mortality over a median follow-up of three years, but was not associated with cardiac mortality. The finding reflects suPAR's role as a non-specific marker of inflammation and comorbidity burden, and could help clinicians identify post-STEMI patients requiring attention for serious non-cardiac conditions during recovery.
The original study
Soluble urokinase receptor as a predictor of non-cardiac mortality in patients with percutaneous coronary intervention treated ST-segment elevation myocardial infarction.
- Authors
- Sandø A, Schultz M, Eugen-Olsen J, Køber L, Engstrøm T, Kelbæk H, et al.
- Journal
- Clinical biochemistry
- Type
- Journal Article, Multicenter Study, Randomized Controlled Trial
- PMID
- 32213303
Original abstract
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- 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.