Key result
Plasma suPAR concentration was independently associated with an increased risk of death or myocardial infarction (HR 1.88 per doubling; P≤0.037) in patients with suspected CAD.
Why the study?
The inflammatory biomarker suPAR is associated with CAD severity and incident death and MI, but this finding needed validation in a further cohort of patients with suspected CAD.
Is plasma suPAR associated with death and adverse cardiovascular outcomes in patients with suspected coronary artery disease?
Cohort (n=1,635)
No
Is plasma suPAR associated with death and adverse cardiovascular outcomes in patients with suspected coronary artery disease?
Hazard Ratio: 1.88
p-value: p=≤0.037
suPAR is an independent predictor of death and MI in patients with suspected or known CAD, though it does not correlate with the presence or severity of CAD.
suPAR may refine risk stratification in suspected CAD; hypothesis-generating pending prospective validation.
Background The inflammatory biomarker soluble urokinase plasminogen activator receptor (suPAR) is associated with presence and severity of coronary artery disease (CAD) and incident death and myocardial infarction (MI). We sought to validate this finding in a further cohort of patients with suspected CAD.Methods Plasma suPAR was available in 1635 patients (73% with CAD) undergoing coronary angiography at a single regional Danish hospital between 2003 and 2005. Patients were followed for adverse cardiovascular outcomes of death, cardiac death and MI over a median follow-up of 4.2 years.Results In multivariate Cox models, adjusted for established cardiovascular risk factors, the biomarkers C-reactive protein, troponin-T and N-terminal-pro brain natriuretic peptide and the number of stenotic vessels, suPAR was independently associated with the combined endpoint of death/MI, hazard ratio (HR) 1.88; cardiovascular death, HR 2.01; and non-fatal MI, HR 1.53; (all p ≤ .037) per doubling of suPAR concentration. A plasma cutoff for suPAR ≥ 3.5 ng/mL was also significantly associated with death/MI, HR 1.51; p = .005. The C-statistic for the multivariate model predicting death/MI improved from 0.712 to 0.730 (p for difference .008) after inclusion of suPAR. However, suPAR was not associated with presence or extent of CAD (p > .05).Conclusion These results validate previous findings that demonstrate suPAR to be an independent predictor of death/MI in patients with suspected or known CAD, however suPAR was not associated with presence or extent of CAD in our cohort. Probably because suPAR reflects end organ damage rather than the degree of atherosclerosis.BRIEF SUMMARY We demonstrate that the inflammatory biomarker soluble urokinase plasminogen activator receptor is an independent predictor of death/myocardial infarction in patients with suspected or known coronary artery disease, but is not associated with the presence or severity of coronary artery disease.
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Hodges et al. (2020) conducted a cohort in suspected coronary artery disease (n=1,635). soluble urokinase plasminogen activator receptor (suPAR) vs. Lower suPAR concentration was evaluated on combined endpoint of death/MI (HR 1.88, p=≤0.037). Plasma suPAR concentration was independently associated with an increased risk of death or myocardial infarction (HR 1.88 per doubling; P≤0.037) in patients with suspected CAD.
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