Soluble urokinase plasminogen activator receptor ( suPAR ) as a prognostic biomarker in acutely admitted patients with atrial fibrillation

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Abstract Background Atrial fibrillation (AF) is associated with a higher incidence of stroke, heart failure, and mortality. Risk assessment of clinical outcomes in patients hospitalized acutely with AF remains a challenge. Purpose To investigate if soluble urokinase plasminogen activator receptor (suPAR) levels at admission to the Emergency Department (ED) are associated with 1‐year all‐cause mortality in patients admitted with AF. Methods A prospective cohort study of patients consecutively admitted to the medical ED of a university hospital in Copenhagen, Denmark, between 2020 and 2022 with symptoms of COVID‐19. Patients were included if they were admitted with AF as the primary or secondary diagnosis. All patients had suPAR measured at the index admission, and follow‐up was up to 1 year. The association between suPAR and 1‐year mortality was investigated with multivariate Cox regression. We adjusted for age, sex, smoking, C‐reactive protein, creatinine, hemoglobin, albumin, and comorbidities. Results Of the 7,258 patients included during the period, 362 (5.0%) patients were admitted with AF as the primary or secondary diagnosis. Due to missing data, 23 (6.4%) patients were excluded. Among the remaining 339 patients, 68 (20.1%) patients were dead at follow‐up. The multivariate Cox regression showed that elevated suPAR was independently associated with an increased risk of 1‐year mortality, with a hazard ratio of 1.12 (95% confidence interval: 1.05–1.20, p < 0.001). Conclusion Elevated suPAR levels were significantly associated with 1‐year all‐cause mortality in patients acutely admitted with AF to the ED.

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