Value of soluble Urokinase plasminogen activator receptor over age as a biomarker of impaired myocardial relaxation.
BACKGROUND
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.


METHODS
We performed conventional and tissue Doppler echocardiography and measured plasma suPAR levels.


RESULTS
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).


CONCLUSION
We demonstrate additional ability of suPAR, over age, to predict impaired myocardial relaxation.


TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02791139 (Registered May 31, 2016).
['Koh|Angela S|AS|', 'Velmurugan|Bhaarathy|B|', 'Gao|Fei|F|', 'Tan|Ru San|RS|', 'Wong|Jia-Ing|JI|', 'Teo|Louis L Y|LLY|', 'Keng|Bryan M H|BMH|', 'Chua|Serene J M|SJM|', 'Yuan|Jian-Min|JM|', 'Koh|Woon-Puay|WP|', 'Cheung|Christine|C|']
D000368:Aged D015415:Biomarkers D016922:Cellular Senescence D003971:Diastole D015150:Echocardiography, Doppler D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009200:Myocardial Contraction D009206:Myocardium D011237:Predictive Value of Tests D012372:ROC Curve D055293:Receptors, Urokinase Plasminogen Activator
Soluble urokinase plasminogen activator receptor Ageing Biomarker Cardiovascular disease Cardiac function Elderly