Evaluating suPAR as an Early Predictor for ACS in ED Patients

Wed Mar 03 2021

“Prognostic value of soluble urokinase plasminogen activator receptor in patients presenting to the Emergency Department with chest pain suggestive of acute coronary syndrome”, published in Clinical Biochemistry

This study aimed to evaluate the early prognostic value of suPAR in patients presenting to the ED with chest pain suggestive of ACS, compared to that of usual cardiac biomarkers.

Previous studies reported that suPAR is elevated in patients with cardiovascular diseases, and is associated with ischemic heart disease and AMI.

This study evaluated the early prognostic value of suPAR in ED patients with chest pain, potentially indicating ACS, and compared it to conventional cardiac biomarkers. Prior research indicates suPAR levels rise in cardiovascular diseases, including ischemic heart disease and AMI.

Researchers enrolled outpatients from three EDs who reported chest pain indicative of ACS within the last 6 hours, excluding those with kidney failure. An emergency physician and a cardiologist, reviewing all patient records from the ED visit to the 30-day follow-up, confirmed diagnoses.

The team monitored patients for 30 days, recording any events like death, ACS relapse, pericarditis, atrial fibrillation, or acute heart failure. Results showed suPAR as an early, independent predictor of outcomes in chest pain patients. A low suPAR, combined with low NT-proBNP levels and a low HEART score at admission, effectively ruled out a 30-day event in one-third of these patients.

Patients experiencing a 30-day event had higher admission suPAR levels than those without. Admission suPAR levels above 3.3 ng/mL independently predicted a 30-day event. Moreover, a combination of suPAR <3.3 ng/mL, NT-proBNP <160 ng/L, and a low HEART score reliably excluded a 30-day event at admission.

The study also suggests the potential of suPAR as a biomarker for guiding patient follow-up post-discharge.

suPAR was an independent early predictor of events in chest pain emergency patients.

Chenevier-Gobeaux, C., et al. Clinical Biochemistry, 2021

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