TY - JOUR
T1 - Soluble urokinase plasminogen activator receptor and functionally relevant coronary artery disease
T2 - a prospective cohort study
AU - Walter, Joan Elias
AU - Amrein, Melissa Lee Fen
AU - Schäfer, Ibrahim
AU - Zimmermann, Tobias
AU - Lopez-Ayala, Pedro
AU - Boeddinghaus, Jasper
AU - Twerenbold, Raphael
AU - Puelacher, Christian
AU - Nestelberger, Thomas
AU - Wussler, Desiree
AU - Honegger, Ursina
AU - Badertscher, Patrick
AU - Eugen-Olsen, Jesper
AU - Koechlin, Luca
AU - Fahrni, Gregor
AU - Jeger, Raban
AU - Kaiser, Christoph
AU - Zellweger, Michael
AU - Mueller, Christian
PY - 2022/5
Y1 - 2022/5
N2 - BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is an emerging biomarker associated with anatomical CAD burden and cardiovascular outcomes including myocardial infarction (MI) and death. We aimed to validate previous findings of the prognostic value of suPAR and to evaluate its diagnostic potential for functional relevant CAD (fCAD).METHODS: Consecutive patients with suspected fCAD were enrolled. Adjudication of fCAD was performed blinded to suPAR concentrations by myocardial perfusion single-photon emission tomography (MPI-SPECT) and coronary angiography. Prognostic outcome measures included all-cause death, cardiovascular death, and incident MI during 2-year follow-up.RESULTS: Among consecutive 968 patients, suPAR concentrations were higher in patients with fCAD compared to those without (3.45 vs. 3.20 ng/mL, p = 0.007), but did not provide acceptable diagnostic accuracy (area under the curve [AUC]: 0.56, 95%CI 0.52-0.60). SuPAR correlated with high-sensitivity cardiac-troponin T (Spearman's rho (ρ) 0.393, p < 0.001), NT-proBNP (ρ = 0.327, p < 0.001), age (ρ = 0.364, p < 0.001) and very weakly with coronary atherosclerosis (ρ = 0.123, p < 0.001). Prognostic discrimination of suPAR was moderate for cardiovascular death (AUC = 0.72, 95%CI 0.62-0.81) and all-cause death (AUC = 0.72, 95%CI 0.65-0.79) at 2-years. SuPAR remained a significant predictor for all-cause death in multivariable Cox regression (HR = 1.96, p = 0.001).CONCLUSIONS: SuPAR was an independent predictor of all-cause death, without diagnostic utility for fCAD.CLINICAL TRIAL REGISTRATION: NCT01838148.
AB - BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is an emerging biomarker associated with anatomical CAD burden and cardiovascular outcomes including myocardial infarction (MI) and death. We aimed to validate previous findings of the prognostic value of suPAR and to evaluate its diagnostic potential for functional relevant CAD (fCAD).METHODS: Consecutive patients with suspected fCAD were enrolled. Adjudication of fCAD was performed blinded to suPAR concentrations by myocardial perfusion single-photon emission tomography (MPI-SPECT) and coronary angiography. Prognostic outcome measures included all-cause death, cardiovascular death, and incident MI during 2-year follow-up.RESULTS: Among consecutive 968 patients, suPAR concentrations were higher in patients with fCAD compared to those without (3.45 vs. 3.20 ng/mL, p = 0.007), but did not provide acceptable diagnostic accuracy (area under the curve [AUC]: 0.56, 95%CI 0.52-0.60). SuPAR correlated with high-sensitivity cardiac-troponin T (Spearman's rho (ρ) 0.393, p < 0.001), NT-proBNP (ρ = 0.327, p < 0.001), age (ρ = 0.364, p < 0.001) and very weakly with coronary atherosclerosis (ρ = 0.123, p < 0.001). Prognostic discrimination of suPAR was moderate for cardiovascular death (AUC = 0.72, 95%CI 0.62-0.81) and all-cause death (AUC = 0.72, 95%CI 0.65-0.79) at 2-years. SuPAR remained a significant predictor for all-cause death in multivariable Cox regression (HR = 1.96, p = 0.001).CONCLUSIONS: SuPAR was an independent predictor of all-cause death, without diagnostic utility for fCAD.CLINICAL TRIAL REGISTRATION: NCT01838148.
KW - CAD
KW - cardiac marker
KW - clinical-utility
KW - risk-stratification
KW - SuPAR
UR - http://www.scopus.com/inward/record.url?scp=85125314790&partnerID=8YFLogxK
U2 - 10.1080/1354750X.2022.2038269
DO - 10.1080/1354750X.2022.2038269
M3 - Journal article
C2 - 35112976
VL - 27
SP - 278
EP - 285
JO - Biomarkers
JF - Biomarkers
SN - 1354-750X
IS - 3
M1 - 2038269
ER -