Abstract

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.

中文翻译：

---

SuPAR 与疑似冠状动脉疾病患者的死亡和不良心血管结局相关。

摘要

背景

炎性生物标志物可溶性尿激酶纤溶酶原激活物受体 (suPAR) 与冠状动脉疾病 (CAD) 的存在和严重程度以及死亡和心肌梗死 (MI) 相关。我们试图在进一步的疑似 CAD 患者队列中验证这一发现。

方法

2003 年至 2005 年期间，在丹麦一家地区医院接受冠状动脉造影的 1635 名患者（73% 患有 CAD）可获得血浆 suPAR。在 4.2 年的中位随访期间，对患者的死亡、心源性死亡和 MI 等不良心血管结局进行了随访.

结果

在多变量 Cox 模型中，针对已确定的心血管危险因素、生物标志物 C 反应蛋白、肌钙蛋白-T 和 N 末端脑利钠肽原和狭窄血管数量进行了调整，suPAR 与死亡/心肌梗死的联合终点独立相关, 风险比 (HR) 1.88; 心血管死亡，HR 2.01；和非致命性 MI，HR 1.53；（所有p  ≤ .037）每 suPAR 浓度增加一倍。suPAR ≥ 3.5 ng/mL 的血浆截止值也与死亡/心肌梗死显着相关，HR 1.51；p  = .005。加入 suPAR 后，预测死亡/MI 的多变量模型的 C 统计量从 0.712 提高到 0.730（差异p为 0.008）。然而，suPAR 与 CAD 的存在或程度无关 ( p  > .05)。

结论

这些结果验证了先前的研究结果，证明 suPAR 是疑似或已知 CAD 患者死亡/心肌梗死的独立预测因子，但在我们的队列中 suPAR 与 CAD 的存在或程度无关。可能是因为 suPAR 反映的是终末器官损伤而不是动脉粥样硬化的程度。

简要概述

我们证明炎症生物标志物可溶性尿激酶纤溶酶原激活物受体是疑似或已知冠状动脉疾病患者死亡/心肌梗死的独立预测因子，但与冠状动脉疾病的存在或严重程度无关。