Soluble urokinase plasminogen activator receptor level is an independent predictor of the presence and severity of coronary artery disease and of future adverse events

Danny J. Eapen, Pankaj Manocha, Nima Ghasemzadeh, Riyaz S. Patel, Hatem Al Kassem, Muhammad Hammadah, Emir Veledar, Ngoc Anh Le, Tomasz Pielak, Christian W. Thorball, Aristea Velegraki, Dimitrios T. Kremastinos, Stamatios Lerakis, Laurence Sperling, Arshed A. Quyyumi

Research output: Contribution to journalArticlepeer-review

92 Scopus citations

Abstract

Introduction-Soluble urokinase plasminogen activator receptor (suPAR) is an emerging inflammatory and immune biomarker. Whether suPAR level predicts the presence and the severity of coronary artery disease (CAD), and of incident death and myocardial infarction (MI) in subjects with suspected CAD, is unknown. Methods and Results-We measured plasma suPAR levels in 3367 subjects (67% with CAD) recruited in the Emory Cardiovascular Biobank and followed them for adverse cardiovascular (CV) outcomes of death and MI over a mean 2.1±1.1 years. Presence of angiographic CAD (≥50% stenosis in ≥1 coronary artery) and its severity were quantitated using the Gensini score. Cox's proportional hazard survival and discrimination analyses were performed with models adjusted for established CV risk factors and C-reactive protein levels. Elevated suPAR levels were independently associated with the presence of CAD (P<0.0001) and its severity (P<0.0001). A plasma suPAR level ≥3.5 ng/mL (cutoff by Youden's index) predicted future risk of MI (hazard ratio [HR] =3.2; P<0.0001), cardiac death (HR=2.62; P<0.0001), and the combined endpoint of death and MI (HR=1.9; P<0.0001), even after adjustment of covariates. The C-statistic for a model based on traditional risk factors was improved from 0.72 to 0.74 (P=0.008) with the addition of suPAR. Conclusion-Elevated levels of plasma suPAR are associated with the presence and severity of CAD and are independent predictors of death and MI in patients with suspected or known CAD.

Original languageEnglish (US)
Article numbere001118
JournalJournal of the American Heart Association
Volume3
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Biomarker
  • C-reactive protein
  • Cardiovascular outcomes
  • Coronary heart disease
  • Inflammation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Soluble urokinase plasminogen activator receptor level is an independent predictor of the presence and severity of coronary artery disease and of future adverse events'. Together they form a unique fingerprint.

Cite this