Soluble urokinase plasminogen activator receptor and functionally relevant coronary artery disease: a prospective cohort study

Joan Elias Walter, Melissa Lee Fen Amrein, Ibrahim Schäfer, Tobias Zimmermann, Pedro Lopez-Ayala, Jasper Boeddinghaus, Raphael Twerenbold, Christian Puelacher, Thomas Nestelberger, Desiree Wussler, Ursina Honegger, Patrick Badertscher, Jesper Eugen-Olsen, Luca Koechlin, Gregor Fahrni, Raban Jeger, Christoph Kaiser, Michael Zellweger, Christian Mueller

3 Citations (Scopus)


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.


Original languageEnglish
Article number2038269
Issue number3
Pages (from-to)278-285
Number of pages8
Publication statusPublished - May 2022


  • CAD
  • cardiac marker
  • clinical-utility
  • risk-stratification
  • SuPAR


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