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Int J Cardiol. 2015 Apr 1;184:631-6. doi: 10.1016/j.ijcard.2015.03.041. Epub 2015 Mar 4.

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

Author information

1
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa. Electronic address: shani.botha@nwu.ac.za.
2
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
3
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council, Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
4
Clinical Research Centre 136, Copenhagen University Hospital, Hvidovre, Denmark.
5
Research to Advance Quality of Nursing & Midwifery (INSINQ), North-West University, Potchefstroom, South Africa.

Abstract

BACKGROUND:

Elevated inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6) are well-known 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 levels were 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<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 all-cause 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.

KEYWORDS:

C-reactive protein; Death; Inflammation; Interleukin-6; Predict; South Africa

PMID:
25771228
DOI:
10.1016/j.ijcard.2015.03.041
[Indexed for MEDLINE]

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