Association between serum soluble urokinase‐type plasminogen activator receptor and atrial fibrillation

Abstract

BackgroundCirculating soluble urokinase-type plasminogen activator receptor (suPAR), which can reflect immune activation and low-grade inflammation, may be a novel biomarker of cardiovascular disease.MethodsWe investigated the potential association between suPAR and the prevalence of atrial fibrillation (AF) by analyzing patients with either sinus rhythm, paroxysmal atrial fibrillation (PAF), or non-paroxysmal atrial fibrillation (NPAF), which indicates either permanent or persistent AF.ResultsAmong 426 patients enrolled (mean age 71.4±9.2 years; 110 (25.8%) female), 310, 62, and 54 were diagnosed with sinus rhythm, PAF, and NPAF, respectively. NPAF was >10-fold more prevalent in the highest suPAR quartile (>3534 pg/mL; 32 (30.2%) of 106 patients) than in the lowest suPAR quartile (<1802 pg/mL; 3 (2.8%) of 107 patients). Logistic regression analysis showed that, as compared with the lowest suPAR quartile, the highest suPAR quartile was associated with NPAF with an odds ratio of 6.48 (95% confidence interval, 1.71–24.5) after adjustment for sex, age, log(eGFR), C-reactive protein, and systolic blood pressure. In multivariate receiver operating characteristic analysis to predict NPAF, the area under the curve (AUC) for the combination of age, sex, log(eGFR), and C-reactive protein was 0.777 (standard error [SE], 0.036); the addition of log(suPAR) slightly improved the prediction (AUC, 0.812; SE, 0.034, P=0.084).ConclusionsSerum suPAR was associated with AF, particularly NPAF, as demonstrated by multivariate logistic regression analysis. Whether suPAR promotes or maintains AF should be investigated in further studies.

Preoperative Levels of the Soluble Urokinase-Type Plasminogen Activator Receptor as Predictor for New Episodes of Atrial Fibrillation After Vascular Surgery

“…After adjustment for CRP and systolic blood pressure, the highest suPAR values remained significantly associated with AF. 9 In our research suPAR alone, or together with CRP, increased the predictive power of traditional risk factors.…”

“…New data indicate the relationship between high suPAR levels and the presence of atrial fibrillation (AF). 9,10 Patients with AF are at an increased risk of developing serious complications, including strokes, heart failure, dementia and early mortality. 11 AF may be present as paroxysmal (self-terminating AF within 7 days), persistent (lasts longer than 7 days) or as long-standing persistent AF (continuous AF for 12 months).…”

Soluble Urokinase Plasminogen Activator Receptor as a Diagnostic and Prognostic Biomarker in Cardiac Disease

“…suPAR may be of value for the evaluation of patients with AF, which may be idiopathic but its prevalence is significantly higher in individuals with other manifestations of cardiac disease. Two retrospective studies among patients admitted to cardiology department, published in 2017, showed that suPAR was associated with AF, particularly non-paroxysmal AF (NPAF) [ 37 ], also was associated with low LVEF and elevated BNP, but not with left ventricular hypertrophy [ 38 ].…”

Prognostic Value of Soluble Urokinase-Type Plasminogen Activator Receptor and High-Sensitivity C-Reactive Protein on Postoperative Mortality in Patients Undergoing Elective On-Pump Cardiac Surgery

“…[11][12][13][14] Moreover, multiple studies have found increasing suPAR values to be prognostic for adverse events and mortality in patients with confirmed or suspected cardiovascular disease. 6,7,[36][37][38][39] To the extent of the authors' knowledge, only one study has investigated suPAR's prognostic ability in relation to cardiac surgery and demonstrated that increasing preoperative levels of suPAR were associated with higher risk of postoperative complications and 30-day mortality. 20 However, the study exclusively comprised patients with aortic stenosis for aortic valve replacement.…”