Wlazeł Rafał N, Migała Marta, Zielińska Marzenna, Pawlicki Lucjan, Rośniak-Bąk Kinga, Szadkowska Iwona
Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, Lodz, Poland.
Department of Intensive Cardiac Therapy, Medical University of Lodz, Lodz, Poland.
Arch Med Sci. 2019 Jan;15(1):72-77. doi: 10.5114/aoms.2016.63596. Epub 2016 Nov 15.
Soluble urokinase plasminogen activator receptor (suPAR) level reflects the general condition of the organism and was proved to give independent information in risk stratification of patients. The aim of this study was to assess the usefulness of suPAR in the prediction of adverse cardiac events in patients with first myocardial infarction (MI) undergoing primary percutaneous coronary intervention. Additionally, the diagnostic power of suPAR was assessed.
One hundred and thirty-nine of 150 consecutive patients were included in the study. Serum suPAR level (ELISA, Virogates) as well as C-reactive protein (on admission and at discharge) and maximum troponin T (assessed from successive 6-hour periods of blood collection) were measured. In the 1-year follow-up study the following major adverse cardiac events were observed: myocardial infarction, revascularization, stroke and death.
Multi-variable analysis revealed prognostic usefulness only for suPAR and glomerular filtration rate: < 0.0001 and = 0.018; OR = 2.59 and OR = 0.98 respectively, with area under the curve in receiver operating characteristic analysis for both parameters simultaneously 0.89 ( < 0.0001). There was no correlation between suPAR level and the left ventricular dysfunction parameters or the MI type.
Soluble urokinase plasminogen activator receptor level appears to be an independent useful biomarker for the prediction of major adverse cardiac events early after first myocardial infarction. The biomarker's level seems to have more prognostic than diagnostic power.
可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平反映机体的总体状况,已被证明在患者风险分层中能提供独立信息。本研究的目的是评估suPAR在预测首次心肌梗死(MI)并接受直接经皮冠状动脉介入治疗患者发生不良心脏事件中的作用。此外,还评估了suPAR的诊断效能。
连续150例患者中的139例纳入本研究。检测血清suPAR水平(酶联免疫吸附测定法,Virogates)以及C反应蛋白(入院时和出院时)和最大肌钙蛋白T(从连续6小时采血时段评估)。在1年的随访研究中,观察到以下主要不良心脏事件:心肌梗死、血运重建、中风和死亡。
多变量分析显示仅suPAR和肾小球滤过率具有预后价值:P<0.0001和P = 0.018;比值比分别为2.59和0.98,两个参数在受试者工作特征分析中的曲线下面积同时为0.89(P<0.0001)。suPAR水平与左心室功能障碍参数或MI类型之间无相关性。
可溶性尿激酶型纤溶酶原激活物受体水平似乎是预测首次心肌梗死后早期主要不良心脏事件的一种独立有用的生物标志物。该生物标志物的水平似乎具有更多的预后价值而非诊断价值。