Can soluble urokinase plasminogen receptor predict outcomes after cardiac surgery?

Schultz-Swarthfigure, C. T., McCall, P. , Docking, R., Galley, H. F. and Shelley, B. (2021) Can soluble urokinase plasminogen receptor predict outcomes after cardiac surgery? Interactive CardioVascular and Thoracic Surgery, 32(2), pp. 236-243. (doi: 10.1093/icvts/ivaa239) (PMID:33236082)

Abstract

Objectives: Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker that has been implicated in several cardiac pathologies and has been shown to be elevated in critically ill populations. We measured plasma suPAR in a cohort of cardiac surgical patients to evaluate its ability to predict prolonged intensive care unit (ICU) and hospital length of stay and development of complications following surgery. We compared suPAR against EuroSCORE II and C-reactive protein (CRP). Methods: Ninety patients undergoing cardiac surgery were recruited with samples taken preoperatively and on postoperative days 1, 2 and 3. suPAR was measured using enzyme-linked immunosorbent assay. Area under the receiver operator curve (AUROC) was used to test predictive capability of suPAR. Comparison was made with EuroSCORE II and CRP. Results: suPAR increased over time (P < 0.001) with higher levels in patients requiring prolonged ICU and hospital stay, and prolonged ventilation (P < 0.05). suPAR was predictive for prolonged ICU and hospital stay, and prolonged ventilation at all time points (AUROC 0.66–0.74). Interestingly, this association was also observed preoperatively, with preoperative suPAR predicting prolonged ICU (AUROC 0.66), and hospital stay (AUROC 0.67) and prolonged ventilation (AUROC 0.74). The predictive value of preoperative suPAR compared favourably to EuroSCORE II and CRP. Conclusions: suPAR increases following cardiac surgery and levels are higher in those who require prolonged ICU stay, prolonged hospital stay and prolonged ventilation. Preoperative suPAR compares favourably to EuroSCORE II and CRP in the prediction of these outcomes. suPAR could be a useful biomarker in predicting outcome following cardiac surgery, helping inform clinical decision-making. Clinical registration: West of Scotland Research Ethics Committee Reference: 12/WS/0179 (AM01).

• Item Type: Articles
• Additional Information: This work was supported by the National Institute of Academic Anaesthesia through the Royal College of Anaesthetists Research, Education and Travel grant via the Ernest Leach Fund to P.M.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Shelley, Dr Benjamin and Docking, Dr Robert and McCall, Dr Philip and Schultz-Swarthfigure, Dr Chase

Creator Roles

Schultz-Swarthfigure, C. T.: Investigation, Methodology, Writing – original draft, Writing – review and editing
McCall, P.: Funding acquisition, Supervision, Writing – review and editing
Docking, R.: Investigation, Methodology, Writing – review and editing
Shelley, B.: Conceptualization, Methodology, Supervision, Writing – review and editing

• Authors: Schultz-Swarthfigure, C. T., McCall, P., Docking, R., Galley, H. F., and Shelley, B.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Interactive CardioVascular and Thoracic Surgery
• Publisher: Oxford University Press
• ISSN: 1569-9293
• ISSN (Online): 1569-9285
• Published Online: 24 November 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Interactive CardioVascular and Thoracic Surgery 32(2): 236-243
• Publisher Policy: Reproduced in accordance with the publisher copyright policy