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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. In an observational study with 339 patients admitted acutely to an Emergency Department with atrial fibrillation, elevated levels of the inflammatory biomarker, soluble urokinase plasminogen activator receptor (suPAR), measured upon admission, were significantly associated with 1‐year all‐cause mortality. Kaplan–Meier plot showing the association between suPAR, stratified according to intervals (≤4ng/mL, 4–6ng/mL, ≥6 ng/mL, and survival probability). suPAR, soluble urokinase plasminogen activator receptor.

BackgroundIncretin-based drugs, including glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs, are increasingly used in the management of type 2 diabetes mellitus and obesity. While these agents have shown cardiovascular benefits, their effects on both cardiovascular outcomes and cardiac structure and function remain uncertain—particularly in patients with and without a history of heart failure (HF).Methods and analysisWe will conduct a systematic review and search major medical databases (Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), Science Citation Index Expanded (SCI-EXPANDED) and Conference Proceedings Citation Index-Science (CPCI-S)), as well as clinical trial registries from their inception and onwards to identify relevant randomised trials. The literature search is scheduled for July 2025. Two review authors will independently extract data and assess risk of bias. We will include randomised controlled trials assessing the effects of cagrilintide/semaglutide, liraglutide, semaglutide and tirzepatide in patients with and without a history of HF. The primary outcome will be cardiovascular mortality. Secondary outcomes will include HF hospitalisation, myocardial infarction, stroke, heart rate, systolic blood pressure, N-terminal pro B-type natriuretic peptide, left ventricular ejection fraction, left ventricular end-diastolic volume and left ventricular end-systolic volume. Data will be synthesised by aggregate data meta-analyses and trial sequential analysis. Risk of bias will be assessed with the Cochrane Risk of Bias tool, version 2, and the certainty of the evidence will be assessed by Grading of Recommendations, Assessment, Development and Evaluations (GRADE).Ethics and disseminationAs this study is a systematic review based on secondary analysis of published data, ethical approval is not required. Findings will be published in international peer-reviewed scientific journals.PROSPERO registration numberCRD420251003374.