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

Abstract

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).

Keywords: Ageing; Biomarker; Cardiac function; Cardiovascular disease; Elderly; Soluble urokinase plasminogen activator receptor.

Conflict of interest statement

Ethics approval and consent to participate

Written informed consent was obtained from participants upon enrolment. The SingHealth Centralised Institutional Review Board had approved the study protocol (2014/628/C).

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1

Receiver operating characteristic (ROC) curves for discriminating between preserved myocardial function and impaired myocardial function using age (blue line) or age plus suPAR (red line)