suPAR is a promising biomarker for prediction of events in chest pain emergency 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.
Outpatients who presented to the ED with chest pain suggestive of ACS with the onset or peak occurring within the previous 6 hours, were prospectively enrolled in three different EDs. Patients with acute or chronic kidney failure were excluded. The gold-standard diagnosis was adjudicated by two independent experts (emergency physician and cardiologist) who reviewed all available medical records pertaining to the patient from the time of ED presentation to 30-day follow-up.
The follow-up of the patients was performed at day 30: if any event occured, the type and date of event was recorded (death, relapse of confirmed or suspected ACS, pericarditis, atrial fibrillation, acute heart failure).
suPAR was an independent early predictor of events in chest pain emergency patients.
Chenevier-Gobeaux, C., et al. Clinical Biochemistry, 2021
The study found that suPAR was an independent early predictor of events in chest pain emergency patients. The association of a low suPAR value and a low NT-proBNP value and a low HEART score at admission allowed to rule out safely a 30-day event in one third of the ED chest pain population.
suPAR concentrations at admission were higher in chest pain patients with a 30-day event in comparison to patients without, and a suPAR value at admission above 3.3 ng/mL was independently associated with a 30-day event. The association of a suPAR <3.3 ng/mL and a NT-proBNP <160 ng/L and a low HEART score had a high negative predictive value to exclude safely a 30-day event at ED admission.
Furthermore, the study may highlight the interest of having a biomarker of ED admission that may be useful to guide patients’ follow-up after discharge.