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Inicio Medicina Clínica (English Edition) Soluble urokinase type plasminogen activator receptor (suPAR) and mortality in a...
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Vol. 163. Issue 6.
Pages 281-285 (September 2024)
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Vol. 163. Issue 6.
Pages 281-285 (September 2024)
Original article
Soluble urokinase type plasminogen activator receptor (suPAR) and mortality in acute pulmonary embolism
Receptor soluble activador del plasminógeno tipo uroquinasa y mortalidad en los pacientes con embolia pulmonar aguda
Crhistian-Mario Oblitasa,b,c, Marina López-Rubioa,b,c,
Corresponding author
marinalopezrubio@outlook.com

Corresponding author.
, Marta-Olimpia Lago-Rodrígueza,b,c, Francisco Galeano-Vallea,b,c, Mercedes García-Gámizd, Angielys Zamora-Trillod, Luis-Antonio Alvarez-Sala Walthera,b,c, Pablo Demelo-Rodrígueza,b,c
a Venous Thromboembolism Unit, Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
b School of Medicine, University Complutense of Madrid, Spain
c Sanitary Research Institute Gregorio Marañón, Madrid, Spain
d Department of Clinical Biochemistry, General University Hospital Gregorio Marañón, Madrid, Spain
Article information
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Tables (2)
Table 1. Demographic, clinical and laboratory characteristics in our population.
Table 2. Bivariate logistic regression analysis for 30-day mortality.
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Abstract
Introduction

The soluble urokinase-type plasminogen activator receptor (suPAR) potentially plays a role in immune-thrombosis, possibly by modulating plasmin activity or contributing to chemotaxis in a complex, poorly understood context. The role of suPAR levels in the short-term prognostic of patients with pulmonary embolism (PE) has not been evaluated.

Material and methods

This observational, prospective, single-center study enrolled consecutive patients aged 18 and above with confirmed acute symptomatic PE and no prior anticoagulant therapy. The primary objective was to assess the prognostic capacity of suPAR levels measured at the time of diagnosis in terms of mortality.

Results

Fifty-two patients, with a mean age of 73.8 years (±17), were included, with gender distribution evenly split at 50%. Seven (13.5%) patients died. The ROC curve for mortality yielded an AUC of 0.72 (95% CI 0.48–0.96), with an optimal suPAR cut-off of 5.5ng/mL. Bivariate analysis for suPAR>5.5ng/mL was associated with a crude odds ratio of 10 (95% CI 1.63–61.27; p=0.01) for 30-day mortality. Survival analysis showed a 30-day mortality hazard ratio of 8.33 (95% CI 1.69–40.99; p<0.01).

Conclusion

suPAR emerges as a potential biomarker for short-term mortality prediction and holds the potential for enhanced stratification in patients with acute symptomatic PE.

Keywords:
Biomarkers
Mortality
Pulmonary embolism
Soluble urokinase-type plasminogen activator receptor (suPAR)
Venous thromboembolism
Resumen
Introducción

El receptor soluble activador del plasminógeno tipo uroquinasa (suPAR) podría participar en la denominada inmunotrombosis, posiblemente regulando la actividad de la plasmina o contribuyendo a la quimiotaxis por mecanismos complejos y aún no esclarecidos. El papel de los niveles de suPAR en el pronóstico a corto plazo en los pacientes con embolia pulmonar (EP) no ha sido evaluado.

Material y métodos

Este estudio observacional, prospectivo y unicéntrico incluyó a pacientes mayores de 18 años, con EP sintomática confirmada y sin tratamiento anticoagulante previo. El objetivo primario fue evaluar la capacidad pronóstica de los niveles del suPAR medidos en el momento del diagnóstico, en términos de mortalidad.

Resultados

Cincuenta y dos pacientes, con una edad media de 73,8 años (±17), fueron incluidos, con una distribución por sexos del 50%. Siete pacientes (13,5%) fallecieron. La curva ROC para mortalidad mostró un AUC de 0,72 (IC 95%: 0,48-0,96), con un punto de corte óptimo del suPAR de 5,5ng/ml. En el análisis bivariable, los niveles de suPAR>5,5ng/ml se asociaron con un odds ratio de 10 (IC 95%: 1,63-61,27; p=0,01) para mortalidad a 30 días. Los análisis de supervivencia mostraron una hazard ratio para mortalidad a los 30 días de 8,33 (IC 95%: 1,69-40,99; p<0,01).

Conclusión

En los pacientes con embolia de pulmón aguda sintomática, el suPAR es un potencial biomarcador para la predicción de mortalidad precoz, y podría ayudar a mejorar la estratificación pronóstica en estos pacientes.

Palabras clave:
Biomarcadores
Mortalidad
Embolia pulmonar
Receptor soluble del plasminógeno tipo uroquinasa (suPAR)
Enfermedad tromboembólica venosa

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