• Eur. J. Clin. Invest. · May 2023

    Soluble urokinase plasminogen activator receptor and survival in elective cardiac surgery.

    • Lorenz Koller, Eva Steinacher, Felix Hofer, Andreas Hammer, Niema Kazem, Guenther Laufer, Tatjana Fleck, Barbara Steinlechner, Johann Wojta, Bernhard Richter, Christian Hengstenberg, Patrick Sulzgruber, and Alexander Niessner.
    • Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
    • Eur. J. Clin. Invest. 2023 May 1; 53 (5): e13953e13953.

    BackgroundThe study investigated the prognostic value of soluble urokinase plasminogen activator receptor (suPAR) in patients undergoing cardiac surgery and calculated a simplified biomarker score comprising suPAR, N-terminal pro B-type natriuretic peptide (NT-proBNP) and age.Methods And ResultsBiomarkers were assessed in a cohort of 478 patients undergoing elective cardiac surgery. After a median follow-up of 4.2 years, a total of 72 (15.1%) patients died. SuPAR, NT-proBNP and age were independent prognosticators of mortality in a multivariable Cox regression model after adjustment for EuroScoreII. We then calculated a simplified biomarker score comprising age, suPAR and NT-proBNP, which had a superior prognostic value compared to EuroScoreII (Harrel's C of 0.76 vs. 0.72; P for difference = 0.02). Besides long-term mortality, the biomarker score had an excellent performance predicting one-year mortality and hospitalization due to heart failure.ConclusionThe biomarker suPAR and NT-proBNP were strongly and independently associated with mortality in patients undergoing cardiac surgery. A simplified biomarker score comprising only three variables (age, suPAR and NT-proBNP) performed better than the established EuroScoreII with respect to intermediate and long-term outcome as well as hospitalization due to heart failure. As such, integration of established and upcoming biomarkers in clinical practice may provide improved decision support in cardiac surgery.© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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