Prognostic value of soluble urokinase‐type plasminogen activator receptor in coronary artery disease: A meta‐analysis

BACKGROUND: A potential inflammatory biomarker, soluble urokinase‐type plasminogen activator receptor (suPAR) has been utilized to assist the prognostic assessment of coronary artery disease (CAD) patients; however, outcomes have been inconsistent. The prognostic relevance of suPAR as a predictor of CAD patient adverse outcomes was therefore examined. METHODS: Research articles published as of 1 January 2022 were retrieved from PubMed, Embase, the Web of Science and the Cochrane Library. All‐cause mortality, cardiovascular mortality and other major cardiovascular events (nonfatal myocardial infarction, heart failure or stroke) were analysed as a subset of relevant studies' results. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each study. The broad EQUATOR guidelines were conformed. Risk of bias was assessed with ROBINS‐I tool. RESULTS: In total, this analysis included nine studies including 14,738 CAD patients. All included studies made a correction for certain potential confounders. However, risk of bias ranged from moderate to critical. When the ROBINS‐I tool was used. Patients with CAD that exhibited increased suPAR levels had a substantially higher risk of all‐cause mortality (HR = 2.24; 95% CI 1.97–2.55) or cardiovascular mortality (HR = 2.02; 95% CI 1.58–2.58), but not of developing other major cardiovascular events (HR = 1.63; 95% CI 0.86–3.11). Considerable heterogeneity across studies was observed in our meta‐analyses, but no significant publication bias was detected. CONCLUSION: In patients with coronary disease, suPAR may have prognostic value for both all‐cause and cardiovascular mortality but not for other major cardiovascular events.