Soluble urokinase plasminogen activator receptor as a prognostic marker of all-cause and cardiovascular mortality in a black population

Abstract

Background: Elevated inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6) are wellknown risk factors for cardiovascular mortality. The less familiar marker, soluble urokinase plasminogen activator receptor (suPAR), is known to predict cancer, infections and all-cause mortality. We determined whether suPAR, CRP and IL-6 are predictive of both all-cause and cardiovascular mortality in a black population, highly burdened by cardiovascular disease and HIV infection." "Methods:We included 1425 black South Africans, of which 208 died within five years after baseline data collection. EDTA plasma biomarker levelswere determined, while all-cause and cardiovascular mortality were used as endpoints." "Results: At baseline suPAR, CRP and IL-6 were higher in non-survivors than in survivors (P b 0.001). SuPAR (HR 1.27, 95% CI 1.09 1.48), IL-6 (HR 1.49, 95% CI 1.24 1.78) and CRP (HR 1.39, 95% CI 1.17 1.65) predicted allcause mortality,while only suPAR (HR 1.40, 95% CI 1.04 1.87) and IL-6 (HR 1.61, 95% CI 1.10 2.35) predicted cardiovascular mortality. The prognostic value of suPAR was independent of IL-6 and CRP (P ? 0.015)." "Conclusion: SuPAR predicted both all-cause and cardiovascular mortality, independent of traditional risk factors, HIV and other inflammatory markers, underlining the prognostic value of suPAR in a black population.