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Open Access 01-12-2019 | Urokinase | Original Paper

Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction

Authors: Nils A. Sörensen, Julius Nikorowitsch, Johannes T. Neumann, Nicole Rübsamen, Alina Goßling, Tau S. Hartikainen, Stefan Blankenberg, Dirk Westermann, Tanja Zeller, Mahir Karakas

Published in: Clinical Research in Cardiology | Issue 12/2019

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).

Available only for authorised users

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Title: Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction
Authors: Nils A. Sörensen
Julius Nikorowitsch
Johannes T. Neumann
Nicole Rübsamen
Alina Goßling
Tau S. Hartikainen
Stefan Blankenberg
Dirk Westermann
Tanja Zeller
Mahir Karakas
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Urokinase
Myocardial Infarction
Acute Coronary Syndrome
Published in: Clinical Research in Cardiology / Issue 12/2019
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-019-01475-1

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Predictive value of soluble urokinase-type plasminogen activator receptor for mortality in patients with suspected myocardial infarction

Abstract

Background

Methods and results

Conclusions

Study registration

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Abstract

Background

Methods and results

Conclusions

Study registration

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