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

Abstract

This review summarizes the published literature referring to the use and validity of the biomarker soluble urokinase plasminogen activator receptor (suPAR) when used for the assessment of patients with cardiac diseases. It is measured by enzyme-linked immunosorbent assay (ELISA) in plasma samples. In cardiology a cutoff value range of 3.5-4.5 ng/mL has been commonly utilized. Different cutoff values may be applied based on the measuring kit used, the patient population and the clinical setting. A PubMed/Medline search was conducted aiming to identify all publications relevant to the use of suPAR in patients with cardiac diseases. A total of 39 studies were included in this review. suPAR as a marker of inflammation has been used more extensively in recent years, alone or in combination with other biomarkers of inflammation and cardiac pathology in the assessment of patients with acute and chronic cardiac diseases. suPAR is closely related to the pathophysiology of cardiac disease, and a number of publications encourages its use as a valuable biomarker in the assessment of patients presenting to the cardiology service. It may be most valuable in the risk assessment of patients with acute coronary syndromes and congestive heart failure, as suPAR elevation may be an independent predictor of mortality in these conditions. In conclusion, among several biomarkers used for clinical entities with underlying inflammatory pathophysiology including cardiac diseases, suPAR is a novel attractive index for the prognostic risk stratification of cardiac patients. More research is warranted to confirm its diagnostic and prognostic validity, alone or combined with other cardiac and inflammatory biomarkers.

Serum and Vascular Stiffness Biomarkers Associated with the Severity of Degenerative Aortic Valve Stenosis and Cardiovascular Outcomes

“…Recent studies showed that the calcification extent in aortic leaflets was associated with the increased secretion of soluble uPAR, a biomarker predictive of cardiovascular outcomes after the intervention on the valve [ 26 , 27 ].…”

Inflammation-Related Biomarkers Are Associated with Heart Failure Severity and Poor Clinical Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy

“…suPAR is a proinflammatory marker originating from proteolytic cleavage and releasing of the membrane-bound urokinase-type plasminogen activator receptor from vascular endothelial and immune cells [24]. It is associated with infectious diseases, systemic inflammation, malignancies [25][26][27] and cardiovascular diseases, predominantly ischemic heart disease [28]. Several studies have analyzed suPAR in chronic heart failure patients, but the results have been inconsistent.…”

Soluble Urokinase Plasminogen Activator Receptor (suPAR) in the Emergency Department (Ed): A Tool for the Assessment of Elderly Patients

“…SuPAR has shown to have excellent prognostic value in both healthy individuals and in individuals with comorbidities [ 16 , 17 , 18 , 19 ]. In critically ill patients, suPAR levels are associated with increased risk of mortality, hospital admission, readmission rates as well as further complications [ 14 , 20 , 21 , 22 , 23 ].…”