Abstract 17781: Elevated Levels of Plasma Soluble Urokinase Plasminogen Activator Receptor is an Independent Predictor of Coronary Microvascular Dysfunction
Background: Soluble urokinase Plasminogen Activator Receptor (suPAR) is a novel biomarker released from inflammatory and endothelial cells that has been associated with cancer and very recently with carotid atherosclerosis. We hypothesized that an elevated plasma suPAR level is an independent predictor of coronary microvascular dysfunction, an early marker of coronary atherosclerosis.
Methods: Invasive coronary blood flow velocity and plasma suPAR levels were evaluated in 66 patients with stable coronary artery disease (CAD) or stabilized acute coronary syndromes. Coronary flow reserve (CFR) was calculated as the ratio of hyperemic/basal average peak blood flow velocity in the left coronary artery and microvascular dysfunction was defined as CFR<2.0. Plasma suPAR levels were measured using ELISA technique. The association between suPAR and CFR was investigated using univariate and multivariate regression analysis.
Results: Mean age was 55±12, 51% were men, and 27% had diabetes. Plasma suPAR values ranged between 0.9-7.0 ng/ml with a mean value of 2.98 ± 1.10 ng/ml. A significant negative linear correlation between suPAR and CFR was observed (r= -0.36, p=0.004). In a multivariate regression analysis, after adjusting for age, sex, tobacco abuse, hypertension, diabetes, dislipidemia, and high sensitivity C-Reactive Protein (hs-CRP), suPAR was found to be an independent predictor of coronary microvascular dysfunction (p=0.008). A doubling of plasma suPAR level was associated with a 32% decrease in CFR value.
Conclusion: In patients with CAD, after adjusting for traditional cardiovascular risk factors and hs-CRP, plasma suPAR level is an independent predictor of coronary microvascular dysfunction. Larger prospective clinical trials are warranted to investigate the relationship between suPAR and adverse cardiovascular events.
- © 2012 by American Heart Association, Inc.