suPAR: A New Biomarker for Cardiovascular Disease?

Hodges, Gethin W.; Bang, Casper N.; Wachtell, Kristian; Eugen‐Olsen, Jesper; Jeppesen, Jørgen

doi:10.1016/j.cjca.2015.03.023

Cited by 93 publications

(80 citation statements)

References 52 publications

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“…suPAR has been shown to outperform hsCRP, another marker of inflammation, in the prognosis of several CVDs (13,24,25), but the diagnostic value of suPAR is considered to be low (26,27). New evidence also suggests that suPAR indicates different pathophysiological pathways than hsCRP in atherosclerosis (28). An earlier populationbased study by Persson et al suggested that plasma suPAR levels are higher in asymptomatic individuals with carotid plaques in comparison to those without plaques.…”

Section: Discussionmentioning

confidence: 93%

Soluble Urokinase-type Plasminogen Activator Receptor Predicts All-cause 5-Year Mortality in Ischemic Stroke and TIA

Onatsu

Taina

Mustonen

et al. 2017

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Section: Discussionmentioning

confidence: 93%

Soluble Urokinase-type Plasminogen Activator Receptor Predicts All-cause 5-Year Mortality in Ischemic Stroke and TIA

Onatsu

Taina

Mustonen

et al. 2017

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“…Although suPAR and CRP are both inflammatory biomarkers, they have been suggested to reflect different aspects of inflammation with suPAR representing inflammation at the cellular level and CRP representing inflammation at the metabolic level. 24 25 The combined information of suPAR and CRP significantly increases the Framingham Risk Score's ability to predict cardiovascular disease and mortality in the general population. 26 The suPAR levels were particularly high in patients with liver or kidney disease.…”

Section: Discussionmentioning

confidence: 99%

Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

et al. 2016

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ObjectiveSoluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker associated with presence and progression of disease and with increased risk of mortality. We aimed to evaluate the unspecific biomarker suPAR as a prognostic marker in patients admitted to acute care.MethodsThis registry-based retrospective cohort study included 4343 consecutively admitted patients from the Acute Medical Unit at a large Danish university hospital. Time to readmission and death were analysed by multiple Cox regression. Results were reported as HRs for 30-day and 90-day follow-up.ResultsDuring 30-day follow-up, 782 patients (18.0%) were readmitted and 224 patients (5.2%) died. Comparing 30-day readmission and mortality between patients in the highest and lowest suPAR quartiles yielded HRs of 2.11 (95% CI 1.70 to 2.62) and 4.11 (95% CI 2.46 to 6.85), respectively, when adjusting for age, sex, Charlson score and C reactive protein. Area under the curve for receiver operating characteristics curve analysis of suPAR for 30-day mortality was 0.84 (95% CI 0.81 to 0.86). Furthermore, in the entire cohort, women had slightly higher suPAR compared with men, and suPAR was associated with age, admission time, admission to intensive care unit and Charlson score.ConclusionsIn this large unselected population of acute medical patients, suPAR is strongly associated with disease severity, readmission and mortality after adjusting for all other risk factors, indicating that suPAR adds information to established prognostic indicators. While patients with low suPAR levels have low risk of readmission and mortality, patients with high suPAR levels have a high risk of adverse events.

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“…Moreover, we and others have previously found that suPAR is a better marker for CVD compared with other markers of inflammation such as high-sensitivity C-reactive protein (13,15,26,27). The reasoning for this may be that suPAR is a marker of vascular inflammation, while C-reactive protein elevations are related to metabolic inflammation (13).…”

Section: Discussionmentioning

confidence: 99%

suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

Theilade

Rossing

Eugen‐Olsen

et al. 2016

European Journal of Endocrinology

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Aim Heart disease is a common fatal diabetes-related complication. Early detection of patients at particular risk of heart disease is of prime importance. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker for development of cardiovascular disease. We investigate if suPAR is associated with early myocardial impairment assessed with advanced echocardiographic methods. Methods In an observational study on 318 patients with type 1 diabetes without known heart disease and with normal left ventricular ejection fraction (LVEF) (biplane LVEF >45%), we performed conventional, tissue Doppler and speckle tracking echocardiography, and measured plasma suPAR levels. Associations between myocardial function and suPAR levels were studied in adjusted models including significant covariates. Results Patients were 55±12 years (mean±s.d.) and 160 (50%) males. Median (interquartile range) suPAR was 3.4 (1.7) ng/mL and LVEF was 58±5%. suPAR levels were not associated with LVEF (P=0.11). In adjusted models, higher suPAR levels were independently associated with both impaired systolic function assessed with global longitudinal strain (GLS) and tissue velocity s′, and with impaired diastolic measures a′ and e′/a′ (all P=0.034). In multivariable analysis including cardiovascular risk factors and both systolic and diastolic measures (GLS and e′/a′), both remained independently associated with suPAR levels (P=0.012). Conclusions In patients with type 1 diabetes with normal LVEF and without known heart disease, suPAR is associated with early systolic and diastolic myocardial impairment. Our study implies that both suPAR and advanced echocardiography are useful diagnostic tools for identifying patients with diabetes at risk of future clinical heart disease, suited for intensified medical therapy.

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suPAR: A New Biomarker for Cardiovascular Disease?

Cited by 93 publications

References 52 publications

Soluble Urokinase-type Plasminogen Activator Receptor Predicts All-cause 5-Year Mortality in Ischemic Stroke and TIA

Soluble Urokinase-type Plasminogen Activator Receptor Predicts All-cause 5-Year Mortality in Ischemic Stroke and TIA

Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

suPAR level is associated with myocardial impairment assessed with advanced echocardiography in patients with type 1 diabetes with normal ejection fraction and without known heart disease or end-stage renal disease

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