Related Experiment Video
Updated: Jul 4, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Proteomics-Based Soluble Urokinase Plasminogen Activator Receptor Levels Are Associated With Adverse Cardiovascular
Shaimaa M Sakr1, Jose R Medina-Inojosa1, Chang Liu2
1Division of Cardiology, Department of Medicine Emory University School of Medicine Atlanta GA.
Insights
Elevated soluble urokinase plasminogen activator receptor (suPAR) predicts cardiovascular events in the general population. Proteomics-based suPAR offers independent predictive value beyond traditional risk factors and genetic variants.
Area of Science:
- Cardiovascular Research
- Biomarkers
- Genetics
Background:
- Elevated soluble urokinase plasminogen activator receptor (suPAR) is linked to inflammation and cardiovascular events in coronary artery disease.
- The PLAUR gene encodes suPAR, with levels influenced by the rs4760 genetic variant.
- The predictive value of proteomics-based suPAR in the general population was previously unknown.
Purpose of the Study:
- To investigate whether proteomics-based suPAR levels predict adverse cardiovascular outcomes in the general population.
- To assess the independent predictive capability of suPAR beyond established risk factors, hs-CRP, and the rs4760 variant.
Main Methods:
- Proteomics-based suPAR levels were measured in 33,963 UK Biobank participants without prior coronary artery disease.
- Fine-Gray and Cox proportional hazards models were used to assess associations with major adverse cardiovascular events and mortality.
- Adjustments were made for demographic, clinical risk factors, hs-CRP, and the rs4760 variant.
Main Results:
- Higher suPAR levels were significantly associated with increased risk of major adverse cardiovascular events (HR, 3.2), cardiovascular mortality (HR, 5.9), and all-cause mortality (HR, 5.0).
- These associations remained significant after adjusting for clinical risk factors, hs-CRP, and the rs4760 variant.
- Proteomics-based suPAR improved risk discrimination beyond clinical factors (C-statistic: 0.719 vs. 0.732, P<0.001).
Conclusions:
- Proteomics-based suPAR is an independent predictor of adverse cardiovascular outcomes in the general population.
- suPAR provides predictive value beyond conventional risk factors, hs-CRP, and genetic predisposition.
- suPAR measurement can enhance cardiovascular risk assessment.
Background:
Elevated soluble urokinase plasminogen activator receptor (suPAR) levels are associated with inflammation, immune activation, and major adverse cardiovascular events in coronary artery disease. Encoded by the PLAUR gene, suPAR levels are influenced by the rs4760 genetic variant. Whether proteomics-based suPAR levels predict adverse outcomes in the general population remains unknown.
Methods:
Proteomics-based suPAR levels were measured using the Olink Immunoassay in 33 963 UK Biobank participants without known coronary artery disease. Fine-Gray and Cox proportional hazards models assessed associations between suPAR and major adverse cardiovascular events (primary outcome: cardiovascular mortality, nonfatal myocardial infarction, or stroke), cardiovascular mortality, and all-cause mortality (secondary outcomes), after adjustment for demographic and clinical risk factors, hs-CRP (high-sensitivity C-reactive protein), and the rs4760 variant. Incremental discrimination was evaluated using C-statistics.
Results:
Participants were aged 56.4 (SD, 8.2) years; 45% were men, and 93.4% were White. Over a median follow-up of 14 years (476 177 person-years), 10.7% experienced major adverse cardiovascular events, 2.6% experienced cardiovascular mortality, and 9.4% experienced all-cause mortality. Each 1-SD increment in proteomics-based suPAR was associated with significantly higher risk of major adverse cardiovascular events (hazard ratio [HR], 3.2 [95% CI, 2.9-4.5]), cardiovascular mortality (HR, 5.9 [95% CI, 5.1-6.9]), and all-cause mortality (HR, 5.0 [95% CI, 4.6-5.5]), independent of clinical risk factors and hs-CRP. Additional adjustment for rs4760 did not attenuate these associations. Proteomics-based suPAR significantly improved discrimination beyond clinical risk factors (C-statistic: 0.719 versus 0.732; P<0.001).
Conclusions:
Proteomics-based suPAR independently predicts adverse cardiovascular outcomes in the general population, beyond conventional risk factors, hs-CRP, and genetic predisposition to elevated suPAR levels.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:29Pharmacogenomics: Identification of New Drug Targets