Thu Oct 13 2022

Soluble Urokinase Plasminogen Activator Receptor Levels and Outcomes in Patients with Heart Failure

Cardiac Failure
Conclusion

suPAR levels are higher in HF compared to non-HF, are strongly predictive of outcomes, and combined with BNP, significantly improved risk prediction.

Highlights

  • Soluble urokinase plasminogen activator receptor (suPAR) is a protein from the immune system linked to kidney disease. Researchers have also linked suPAR levels to the risk of heart failure.

  • Considering the connection between heart failure and kidney disease, we focused on suPAR levels in heart failure patients.

  • In our study, we tested suPAR levels in 1,116 patients with heart failure. The results showed that suPAR levels strongly predict outcomes. This prediction holds even when considering other risk factors and the heart marker BNP. Thus, suPAR levels could help in assessing the risk for patients with heart failure.

Methods and results

We measured plasma suPAR and BNP levels in 3,437 patients undergoing coronary angiogram. We followed these patients for a median of 6.2 years. Our study aimed to analyze survival for all-cause death, cardiovascular death, and hospitalization for heart failure (HF). We also evaluated how well suPAR could predict these outcomes. Our study included 1,116 HF patients (age 65±12, 67.2% male, 20.0% Black, 67% with reduced ejection fraction). HF patients showed higher median suPAR levels (3370 [IQR 2610-4371] pg/mL) compared to those without HF (2880 [IQR 2270-3670] pg/mL, P<0.001). For HF patients, higher suPAR levels (log-base 2) significantly linked to increased risks of all-cause death (adjusted hazard ratio aHR 2.30, 95%CI[1.90-2.77]), cardiovascular death (aHR 2.33 95%CI[1.81-2.99]), and HF hospitalization (aHR 1.96, 95%CI[1.06-1.25]). These links were independent of clinical characteristics and BNP levels. This association was consistent across different subgroups and did not vary with the type of cardiomyopathy or ejection fraction status. Adding suPAR to a model that includes BNP levels significantly improved the accuracy for predicting death (Δ0.027), cardiovascular death (Δ0.017), and HF hospitalization (Δ0.017).

1000+

published suPAR studies in leading medical journals

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