Soluble urokinase plasminogen activator receptor for risk prediction in patients admitted with acute chest pain

Stig Lyngbæk*, Charlotte Andersson, Jacob L. Marott, Daniél V. Møller, Michael Christiansen, Kasper K. Iversen, Peter Clemmensen, Jesper Eugen-Olsen, Peter R. Hansen, Jørgen L. Jeppesen

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelpeer review

    Abstract

    BACKGROUND: Plasma concentrations of soluble urokinase plasminogen activator receptor (suPAR) predict mortality in several clinical settings, but the long-term prognostic importance of suPAR in chest pain patients admitted on suspicion of non-ST-segment elevation acute coronary syndrome (NSTEACS) is uncertain. METHODS: suPAR concentrations were measured on admission in 449 consecutive chest pain patients in a single center between January 3, 2005, and February 14, 2006. Patients were followed for all-cause mortality from discharge until July 28, 2011. RESULTS: The diagnoses at discharge comprised highrisk NSTEACS [non-ST elevation myocardial infarction or unstable angina with electrocardiogram (ECG) abnormalities] in 77 patients (17.2%) and low-risk NSTEACS without evidence of myocardial ischemia in 257 (57.2%) of patients. Another 115 (25.6%) of patients received other diagnoses. During a median follow-up of 5.7 years (range, 0.01- 6.6 years) there were 162 (36.1%) deaths. suPAR was predictive of mortality independent of age, sex, smoking, final diagnosis for the hospitalization, comorbidities (diabetes, hypertension, previous myocardial infarction, and heart failure), and variables measured on the day of admission (renal function, inflammatory markers, and markers of myocardial ischemia) with a hazard ratio (95% CI) of 1.93 (1.48 -2.51) per SD increase in logtransformed suPAR, P < 0.0001. The use of suPAR improved the predictive accuracy of abnormal ECG findings and increased troponin concentrations regarding all-cause mortality (c statistics, 0.751- 0.805; P < 0.0001). CONCLUSIONS: suPAR is a strong predictor of adverse long-term outcomes and improves risk stratification beyond traditional risk variables in chest pain patients admitted with suspected NSTEACS.

    OriginalsprogEngelsk
    Sider (fra-til)1621-1629
    Antal sider9
    TidsskriftClinical Chemistry
    Vol/bind59
    Udgave nummer11
    DOI
    StatusUdgivet - 1 nov. 2013

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