Soluble Urokinase Plasminogen Activated Receptor in Type 2 Diabetes Mellitus Patients Undergoing Coronary Artery Bypass Grafting: A Prospective Interventional Cohort Study

Objectives: Elevated levels of soluble urokinase plasminogen activator receptor (suPAR) increase mortality in various systemic diseases. This has been shown amply in recent literature. The primary aim of the study was to investigate that whether this increase in suPAR levels have same results in type 2 diabetes mellitus (T2DM) patients undergoing coronary artery bypass grafting (CABG). We also aimed to observe the duration of mechanical ventilation and length of stay in the intensive care unit in these patients as our secondary aim. Materials and Methods: Blood samples of adult patients having T2DM admitted for elective on-pump CABG surgery were collected after induction of anesthesia before skin incision (T1) and 48 h post-cardiopulmonary bypass (CPB) (T2) from the year 2022 to 2023. The study was conducted on 196 patients of either sex of age at least 18 years with T2DM with the American Society of Anesthesiologists status III to IV. Patients were randomly divided into 2 groups with alternative allocation. Patients of the study group ( n = 96) were measured suPAR, high-sensitivity C-reactive protein (hsCRP), and blood sugar, while patients of the control group ( n = 100) were measured hsCRP and blood sugar only. Threshold suPAR levels for predicting mortality in the immediate post-operative period were assessed through receiver operating characteristic curves and optimal values decided using Youden’s Index. Results: There was a significant rise in suPAR and hs-CRP levels before the start of surgery and 48 h post-CPB ( P < 0.001). Conclusion: In patients with T2DM undergoing on-pump CABG, increased pre-bypass, and especially 48-h post-CPB, levels of suPAR and hsCRP predict more mortality.