Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock

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...

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Autores: Hongisto, Mari|||0000-0002-9838-1248, Lassus, Johan, Tarvasmäki, Tuukka|||0000-0003-3406-243X, Sans-Roselló, Jordi|||0000-0003-3176-6191, Tolppanen, Heli|||0000-0002-3364-8554, Kataja, Anu, Jäntti, Toni|||0000-0001-8348-0844, Sabell, Tuija|||0000-0003-2764-7253, Banaszewski, Marek, Silva-Cardoso, Jose, Parissis, John, Jurkko, Raija, Spinar, Jindrich, Castrén, Maaret|||0000-0001-7164-4733, Mebazaa, Alexandre|||0000-0001-8715-7753, Masip, Josep|||0000-0002-8612-9889, Harjola, Veli-Pekka
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:268213
Acceso en línea:https://ddd.uab.cat/record/268213
https://dx.doi.org/urn:doi:10.1093/ehjacc/zuac096
Access Level:acceso abierto
Palabra clave:Cardiogenic shock
Supar
Risk stratification
Biomarker
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spelling Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shockHongisto, Mari|||0000-0002-9838-1248Lassus, JohanTarvasmäki, Tuukka|||0000-0003-3406-243XSans-Roselló, Jordi|||0000-0003-3176-6191Tolppanen, Heli|||0000-0002-3364-8554Kataja, AnuJäntti, Toni|||0000-0001-8348-0844Sabell, Tuija|||0000-0003-2764-7253Banaszewski, MarekSilva-Cardoso, JoseParissis, JohnJurkko, RaijaSpinar, JindrichCastrén, Maaret|||0000-0001-7164-4733Mebazaa, Alexandre|||0000-0001-8715-7753Masip, Josep|||0000-0002-8612-9889Harjola, Veli-PekkaCardiogenic shockSuparRisk stratificationBiomarkerSoluble 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.Universitat Autònoma de Barcelona 22022-01-0120222022-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/268213https://dx.doi.org/urn:doi:10.1093/ehjacc/zuac096reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest 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.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2682132026-06-06T12:50:31Z
dc.title.none.fl_str_mv Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
title Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
spellingShingle Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
Hongisto, Mari|||0000-0002-9838-1248
Cardiogenic shock
Supar
Risk stratification
Biomarker
title_short Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
title_full Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
title_fullStr Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
title_full_unstemmed Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
title_sort Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
dc.creator.none.fl_str_mv Hongisto, Mari|||0000-0002-9838-1248
Lassus, Johan
Tarvasmäki, Tuukka|||0000-0003-3406-243X
Sans-Roselló, Jordi|||0000-0003-3176-6191
Tolppanen, Heli|||0000-0002-3364-8554
Kataja, Anu
Jäntti, Toni|||0000-0001-8348-0844
Sabell, Tuija|||0000-0003-2764-7253
Banaszewski, Marek
Silva-Cardoso, Jose
Parissis, John
Jurkko, Raija
Spinar, Jindrich
Castrén, Maaret|||0000-0001-7164-4733
Mebazaa, Alexandre|||0000-0001-8715-7753
Masip, Josep|||0000-0002-8612-9889
Harjola, Veli-Pekka
author Hongisto, Mari|||0000-0002-9838-1248
author_facet Hongisto, Mari|||0000-0002-9838-1248
Lassus, Johan
Tarvasmäki, Tuukka|||0000-0003-3406-243X
Sans-Roselló, Jordi|||0000-0003-3176-6191
Tolppanen, Heli|||0000-0002-3364-8554
Kataja, Anu
Jäntti, Toni|||0000-0001-8348-0844
Sabell, Tuija|||0000-0003-2764-7253
Banaszewski, Marek
Silva-Cardoso, Jose
Parissis, John
Jurkko, Raija
Spinar, Jindrich
Castrén, Maaret|||0000-0001-7164-4733
Mebazaa, Alexandre|||0000-0001-8715-7753
Masip, Josep|||0000-0002-8612-9889
Harjola, Veli-Pekka
author_role author
author2 Lassus, Johan
Tarvasmäki, Tuukka|||0000-0003-3406-243X
Sans-Roselló, Jordi|||0000-0003-3176-6191
Tolppanen, Heli|||0000-0002-3364-8554
Kataja, Anu
Jäntti, Toni|||0000-0001-8348-0844
Sabell, Tuija|||0000-0003-2764-7253
Banaszewski, Marek
Silva-Cardoso, Jose
Parissis, John
Jurkko, Raija
Spinar, Jindrich
Castrén, Maaret|||0000-0001-7164-4733
Mebazaa, Alexandre|||0000-0001-8715-7753
Masip, Josep|||0000-0002-8612-9889
Harjola, Veli-Pekka
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Cardiogenic shock
Supar
Risk stratification
Biomarker
topic Cardiogenic shock
Supar
Risk stratification
Biomarker
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/268213
https://dx.doi.org/urn:doi:10.1093/ehjacc/zuac096
url https://ddd.uab.cat/record/268213
https://dx.doi.org/urn:doi:10.1093/ehjacc/zuac096
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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