University of Oulu

Hodges GW, Bang CN, Eugen-Olsen J, et al SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis Open Heart 2018;5:e000743. doi: 10.1136/openhrt-2017-000743

SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis

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Author: Hodges, Gethin W1; Bang, Casper N2; Eugen-Olsen, Jesper3;
Organizations: 1Department of Medicine, Amager Hvidovre Hospital Glostrup, University of Copenhagen, Copenhagen, Denmark
2Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
3Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
4Department of Internal Medicine, Holbaek Hospital, Holbæk, Denmark
5Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark
6Research Unit, Skellefteå, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
7Department of Cardiology, University Hospitals of South Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
8Research Institute of Internal Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
9Department of Cardiology, Oslo University Hospital, Oslo, Norway
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: BMJ, 2018
Publish Date: 2018-04-25


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: aseline 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.

Conclusions: 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.

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Series: Open heart
ISSN: 2398-595X
ISSN-E: 2053-3624
ISSN-L: 2398-595X
Volume: 5
Issue: 1
Article number: e000743
DOI: 10.1136/openhrt-2017-000743
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was partly funded by the Novo Nordisk Foundation.
Copyright information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: