SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis
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SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis. / Hodges, Gethin W; Bang, Casper N; Eugen-Olsen, Jesper; Olsen, Michael H; Boman, Kurt; Ray, Simon; Kesäniemi, Antero Y; Jeppesen, Jørgen L; Wachtell, Kristian.
In: Open Heart, Vol. 5, No. 1, 2018, p. e000743.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis
AU - Hodges, Gethin W
AU - Bang, Casper N
AU - Eugen-Olsen, Jesper
AU - Olsen, Michael H
AU - Boman, Kurt
AU - Ray, Simon
AU - Kesäniemi, Antero Y
AU - Jeppesen, Jørgen L
AU - Wachtell, Kristian
PY - 2018
Y1 - 2018
N2 - Background: We evaluated whether early measurement of soluble urokinase plasminogen activator receptor (suPAR) could predict future risk of postoperative complications in initially asymptomatic patients with mild-moderate aortic stenosis (AS) undergoing aortic valve replacement (AVR) surgery.Methods: Baseline plasma suPAR levels were available in 411 patients who underwent AVR surgery during follow-up in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Cox analyses were used to evaluate suPAR in relation to all-cause mortality and the composite endpoint of postoperative complications (all-cause mortality, congestive heart failure, stroke and renal impairment) occurring in the 30-day postoperative period.Results: Patients with initially higher levels of suPAR were at increased risk of postoperative mortality with a HR of 3.5 (95% CI 1.4 to 9.0, P=0.008) and postoperative complications with a HR of 2.7 (95% CI 1.5 to 5.1, P=0.002), per doubling in suPAR. After adjusting for the European System for Cardiac Operative Risk Evaluation or Society of Thoracic Surgeons risk score, suPAR remained associated with postoperative mortality with a HR 3.2 (95% CI 1.2 to 8.6, P=0.025) and 2.7 (95% CI 1.0 to 7.8, P=0.061); and postoperative complications with a HR of 2.5 (95% CI 1.3 to 5.0, P=0.007) and 2.4 (95% CI 1.2 to 4.8, P=0.011), respectively.Conclusion: Higher baseline suPAR levels are associated with an increased risk for postoperative complications and mortality in patients with mild-moderate, asymptomatic AS undergoing later AVR surgery. Further validation in other subsets of AS individuals are warranted.Trial registration number: NCT00092677; Post-results.
AB - Background: We evaluated whether early measurement of soluble urokinase plasminogen activator receptor (suPAR) could predict future risk of postoperative complications in initially asymptomatic patients with mild-moderate aortic stenosis (AS) undergoing aortic valve replacement (AVR) surgery.Methods: Baseline plasma suPAR levels were available in 411 patients who underwent AVR surgery during follow-up in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Cox analyses were used to evaluate suPAR in relation to all-cause mortality and the composite endpoint of postoperative complications (all-cause mortality, congestive heart failure, stroke and renal impairment) occurring in the 30-day postoperative period.Results: Patients with initially higher levels of suPAR were at increased risk of postoperative mortality with a HR of 3.5 (95% CI 1.4 to 9.0, P=0.008) and postoperative complications with a HR of 2.7 (95% CI 1.5 to 5.1, P=0.002), per doubling in suPAR. After adjusting for the European System for Cardiac Operative Risk Evaluation or Society of Thoracic Surgeons risk score, suPAR remained associated with postoperative mortality with a HR 3.2 (95% CI 1.2 to 8.6, P=0.025) and 2.7 (95% CI 1.0 to 7.8, P=0.061); and postoperative complications with a HR of 2.5 (95% CI 1.3 to 5.0, P=0.007) and 2.4 (95% CI 1.2 to 4.8, P=0.011), respectively.Conclusion: Higher baseline suPAR levels are associated with an increased risk for postoperative complications and mortality in patients with mild-moderate, asymptomatic AS undergoing later AVR surgery. Further validation in other subsets of AS individuals are warranted.Trial registration number: NCT00092677; Post-results.
U2 - 10.1136/openhrt-2017-000743
DO - 10.1136/openhrt-2017-000743
M3 - Journal article
C2 - 29387432
VL - 5
SP - e000743
JO - Open Heart
JF - Open Heart
SN - 2398-595X
IS - 1
ER -
ID: 212955257