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Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events
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, i...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323820/ https://www.ncbi.nlm.nih.gov/pubmed/25341887 http://dx.doi.org/10.1161/JAHA.114.001118 |
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author | Eapen, Danny J. Manocha, Pankaj Ghasemzedah, Nima Patel, Riyaz S. Al Kassem, Hatem Hammadah, Muhammad Veledar, Emir Le, Ngoc‐Anh Pielak, Tomasz Thorball, Christian W. Velegraki, Aristea Kremastinos, Dimitrios T. Lerakis, Stamatios Sperling, Laurence Quyyumi, Arshed A. |
author_facet | Eapen, Danny J. Manocha, Pankaj Ghasemzedah, Nima Patel, Riyaz S. Al Kassem, Hatem Hammadah, Muhammad Veledar, Emir Le, Ngoc‐Anh Pielak, Tomasz Thorball, Christian W. Velegraki, Aristea Kremastinos, Dimitrios T. Lerakis, Stamatios Sperling, Laurence Quyyumi, Arshed A. |
author_sort | Eapen, Danny J. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4323820 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-43238202015-02-23 Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events Eapen, Danny J. Manocha, Pankaj Ghasemzedah, Nima Patel, Riyaz S. Al Kassem, Hatem Hammadah, Muhammad Veledar, Emir Le, Ngoc‐Anh Pielak, Tomasz Thorball, Christian W. Velegraki, Aristea Kremastinos, Dimitrios T. Lerakis, Stamatios Sperling, Laurence Quyyumi, Arshed A. J Am Heart Assoc Original Research 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. Blackwell Publishing Ltd 2014-10-23 /pmc/articles/PMC4323820/ /pubmed/25341887 http://dx.doi.org/10.1161/JAHA.114.001118 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Eapen, Danny J. Manocha, Pankaj Ghasemzedah, Nima Patel, Riyaz S. Al Kassem, Hatem Hammadah, Muhammad Veledar, Emir Le, Ngoc‐Anh Pielak, Tomasz Thorball, Christian W. Velegraki, Aristea Kremastinos, Dimitrios T. Lerakis, Stamatios Sperling, Laurence Quyyumi, Arshed A. Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events |
title | Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events |
title_full | Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events |
title_fullStr | Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events |
title_full_unstemmed | Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events |
title_short | Soluble Urokinase Plasminogen Activator Receptor Level Is an Independent Predictor of the Presence and Severity of Coronary Artery Disease and of Future Adverse Events |
title_sort | soluble urokinase plasminogen activator receptor level is an independent predictor of the presence and severity of coronary artery disease and of future adverse events |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323820/ https://www.ncbi.nlm.nih.gov/pubmed/25341887 http://dx.doi.org/10.1161/JAHA.114.001118 |
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