Prognostic value of suPAR and hs-CRP on cardiovascular disease

Area of Science:

• Cardiology
• Biomarkers
• Risk Prediction

Background:

• Cardiovascular (CV) disease remains a leading cause of mortality.
• Soluble urokinase Plasminogen Activator Receptor (suPAR), C-reactive protein (CRP), and coronary artery calcification (CAC) are recognized as independent CV disease risk predictors.
• The incremental prognostic value of suPAR and CRP beyond established risk factors and CAC requires further investigation.

Purpose of the Study:

• To evaluate the added predictive value of suPAR and CRP in cardiovascular risk assessment.
• To determine if suPAR and CRP improve risk stratification beyond traditional CV risk factors and CAC scores.

Main Methods:

• A cohort of 1179 subjects without pre-existing CV disease was analyzed.
• Traditional CV risk factors, CAC scores, and plasma levels of suPAR and CRP were assessed.
• Cardiovascular events were tracked for 6.5 years using national health registers.
• Statistical analyses included Kaplan Meier, adjusted hazard ratios, and Receiver Operating Characteristic (ROC) area under the curve (AUC) models.

Main Results:

• suPAR and CRP showed significant associations with CV events in unadjusted analyses (p=0.03 and p=0.002, respectively).
• After adjusting for traditional CV risk factors and CAC score, suPAR and CRP demonstrated minor predictive importance (HRs 1.17 and 1.04).
• suPAR indicated a notable risk in specific subgroups: women (HR 2.03) and individuals aged 60 (HR 1.44).
• ROC AUC analysis indicated that suPAR and CRP did not significantly enhance predictive accuracy compared to traditional factors or CAC score.

Conclusions:

• suPAR and CRP showed limited incremental value for cardiovascular risk prediction when adjusted for traditional risk factors and CAC score.
• While suPAR and CRP are associated with CV events, their role in refining risk stratification in conjunction with established markers is minimal.