Prognostic value of suPAR and hsCRP on postoperative mortality in patients undergoing elective on-pump cardiac surgery

Abstract Objectives Elevated soluble urokinase-type plasminogen activator receptor (suPAR) and high-sensitivity C-Reactive Protein (hsCRP) have been associated with increased mortality in patients with cardiovascular disease. The aim of study was to explore relationship between suPAR and hsCRP-values and associated mortality after elective cardiac surgery. Further, to assess whether a combined risk model of EuroSCORE II, suPAR and/or hsCRP improve the prognostic accuracy compared with EuroSCORE II alone. Design Retrospective observational study. Setting Single-center, university hospital. Participants Adult patients admitted for elective on-pump cardiac surgery were included. Biobank blood samples were obtained from previous research projects at a tertiary Heart Centre between 2012 to 2018. Interventions None Measurements and main results A total of 931 patients were included. Kaplan-Meier and Cox proportional hazard analysis were used to explore a potential association between pre-operative suPAR and hsCRP-values and all-cause mortality up to 1-year after surgery. Thirty-days mortality was predicted from suPAR, hsCRP and EuroSCORE II by logistic regression and compared using area under the ROC curve and Brier scores. Following adjustment for known confounders, a doubling of suPAR and hsCRP corresponded to a hazard ratio (HR) for all-cause mortality of 2.27 (95% CI 1.65 to 3.11, p Conclusions Elevated pre-operative levels of suPAR and hsCRP were associated with all-cause mortality in elective cardiac surgery patients. However, inclusion of biomarkers did not improve the prognostic accuracy of EuroSCORE II.