J 2022

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

HONGISTO, Mari, Johan LASSUS, Tuukka TARVASMAKI, Jordi SANS-ROSELLO, Heli TOLPPANEN et. al.

Základní údaje

Originální název

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

Autoři

HONGISTO, Mari (garant), Johan LASSUS, Tuukka TARVASMAKI, Jordi SANS-ROSELLO, Heli TOLPPANEN, Anu KATAJA, Toni JANTTI, Tuija SABELL, Marek BANASZEWSKI, Jose SILVA-CARDOSO, John PARISSIS, Raija JURKKO, Jindřich ŠPINAR (203 Česká republika, domácí), Maaret CASTREN, Alexandre MEBAZAA, Josep MASIP, Veli Pekka HARJOLA a CardShock Study Investigators And The Great NETWORK

Vydání

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, LONDON, SAGE PUBLICATIONS LTD, 2022, 2048-8726

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 4.100

Kód RIV

RIV/00216224:14110/22:00128426

Organizační jednotka

Lékařská fakulta

UT WoS

000838679300001

Klíčová slova anglicky

Cardiogenic shock; suPAR; Risk stratification; Biomarker

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 31. 1. 2023 09:40, Mgr. Tereza Miškechová

Anotace

V originále

Aims 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. Methods and results 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(12h)) 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(12h) > 4.4 ng/mL to the CardShock risk score improved discrimination identifying high-risk patients originally categorized in the intermediate-risk category. Conclusion SuPAR associates with mortality and improves risk stratification independently of other previously known risk factors in CS patients.