title: The inflammatory marker suPAR after cardiac arrest.
abstract: BACKGROUND
  Soluble urokinase plasminogen activator receptor (suPAR) is released in response to inflammatory stimuli, and plasma levels are associated with long-term outcomes. The ischemia/reperfusion injury caused by cardiac arrest (CA) and resuscitation triggers an inflammatory response. This pilot study aimed at investigating suPAR levels in relation to outcome after CA and mild induced hypothermia.
  
  
  METHODS
  suPAR levels were measured at 6, 36, and 72 hours in patients treated with hypothermia after CA. suPAR levels were analyzed in relation to survival after 6 months. Receiver operating characteristic curve (ROC)-analyses were performed, and area under the curve (AUC) was calculated. Time to return of spontaneous circulation (ROSC) was correlated to suPAR levels.
  
  
  RESULTS
  Fifty-five patients (40 male, median 65 years) were included, and 33 (60%) were alive after 6 months. The suPAR levels were significantly higher in nonsurviving patients compared with survivors at 6 and 36 hours (p=0.006 and 0.034 respectively), but not at 72 hours. The suPAR levels increased from 6 to 72 hours (p<0.0001). Time to ROSC correlated positively with suPAR levels at 6 hours (p=0.003) but not at 36 and 72 hours. ROC analysis shoved an AUC of 0.76 at 6 hours. In the subgroup of CA of cardiac cause, the AUC was 0.84.
  
  
  CONCLUSIONS
  suPAR levels at 6 and 36 hours after CA were significantly higher in nonsurviving patients compared with survivors; however, the overlap in suPAR levels between the outcome groups was substantial, reducing the prognostic value. There was a significant increase in suPAR levels during the first 72 hours after CA.
authors.affiliation: 1 Department of Clinical Sciences, Anaesthesia and Intensive Care, Skane University Hospital, Lund University , Lund, Sweden .
authors.forename: Malin
authors.initials: M
authors.lastname: Rundgren
authors.affiliation: 2 Copenhagen University Hospital , Glostrup, Denmark .
authors.forename: Stig
authors.initials: S
authors.lastname: Lyngbaek
authors.affiliation: 3 ViroGates , Birkerød, Denmark .
authors.forename: Helle
authors.initials: H
authors.lastname: Fisker
authors.affiliation: 1 Department of Clinical Sciences, Anaesthesia and Intensive Care, Skane University Hospital, Lund University , Lund, Sweden .
authors.forename: Hans
authors.initials: H
authors.lastname: Friberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001833:Body Temperature Regulation; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; C524898:PLAUR protein, human; D055293:Receptors, Urokinase Plasminogen Activator