Koh, A.S., Velmurugan, B., Gao, F. et al. Value of soluble Urokinase plasminogen activator receptor over age as a biomarker of impaired myocardial relaxation. BMC Geriatr 17, 275 (2017). https://doi.org/10.1186/s12877-017-0668-0
SuPAR is a biomarker that reflects the level of immune activation. As inflammation plays an important role in the ageing process of the cardiovascular system, we hypothesized that suPAR might be a useful predictive biomarker of the ageing heart.
We performed conventional and tissue Doppler echocardiography and measured plasma suPAR levels.
We studied community adults (n=120, 37.5% female) (mean age: 70.3±9.3 years) without known cardiovascular disease (CVD). Participants with impaired myocardial relaxation were older (84% vs 59% were aged ≥71 years, p=0.002), with more diabetes mellitus (27% vs 11%, p=0.034). SuPAR levels were higher among participants with impaired myocardial relaxation (3.9 ng/ml vs 3.0 ng/ml, p=0.015). At the univariate level, older age (OR 3.6; 95%CI 1.6, 8.5; p=0.003), diabetes mellitus (OR 3.04; 95%CI 1.1, 8.8; p=0.04), systolic blood pressure (OR 1.03; 95%CI 1.001, 1.1; p=0.041) and suPAR levels ≥3.00ng/ml (OR 3.4; 95%CI 1.16, 7.4; p=0.002) were associated with impaired myocardial relaxation. In multivariable regression analysis, only older age (OR 2.8; 95%CI 1.1, 6.7; p=0.026) and suPAR (OR 2.7; 95%CI 1.2, 6.1; p=0.018) remained independently associated with impaired myocardial relaxation. Receiver operating characteristics (ROC) curve analysis revealed an area under the curve (AUC) value of 0.63 (95% CI 0.54, 0.71) for model that included age alone. Addition of suPAR significantly increased AUC value to 0.70 (95%CI 0.60, 0.79), which was significantly larger than the model with age alone (p=0.016).
We demonstrate additional ability of suPAR, over age, to predict impaired myocardial relaxation.
ClinicalTrials.gov Identifier: NCT02791139 (Registered May 31, 2016).
The Cardiac Aging Study has received funding support from the National Medical Research Council of Singapore (NMRC/TA/0031/2015), Hong Leong Foundation and Edwards Lifesciences. Participants from the Singapore Chinese Health Study were supported by the United States National Institutes of Health (NIH R01 CA144034 and UM1 CA182876). C.Cheung was supported by a Nanyang Assistant Professorship, Singapore, and an IMCB Independent Fellowship (A*STAR). The funder had no role in the design and conduct of the study; collection; management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.