Abstract
Background
Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory marker
associated with subclinical cardiovascular damage and cardiovascular events. Whether
suPAR is of prognostic value in asymptomatic patients with aortic stenosis (AS) remains
unknown.
Methods
Plasma suPAR levels were measured in 1503 patients with a mean age of 68 years who
were recruited in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Cox regression analysis was performed to evaluate associations
between suPAR and the composite end points of ischemic cardiovascular events (ICEs),
aortic valve events (AVEs), cardiovascular and all-cause mortality after adjusting
for traditional cardiovascular risk factors, and allocation to treatment.
Results
The multivariate adjusted hazard ratio (HR) (95% confidence interval [CI]) per unit
log2 ng/mL increase in suPAR was HR, 1.5; 95% CI, 1.2-1.9; P = 0.002 for ICEs; HR, 1.2; 95% CI, 0.9-1.5; P = 0.071) for AVEs; HR, 2.0; 95% CI, 1.2-3.3; P = 0.007) for cardiovascular mortality, and HR, 2.0; 95% CI, 1.4-2.9; P < 0.001 for all-cause mortality.
Conclusions
In patients with mild-moderate AS, suPAR is independently associated with the incidence
of ICEs, cardiovascular mortality, and all-cause mortality.
Résumé
Introduction
Le récepteur soluble de l’activateur du plasminogène de l’urokinase (suPAR, soluble urokinase plasminogen activator receptor) est un marqueur de l’inflammation associé aux lésions cardiovasculaires subcliniques
et aux événements cardiovasculaires. Or, on ignore encore si le suPAR a une valeur
pronostique chez les patients présentant une sténose aortique asymptomatique.
Méthodes
La concentration plasmatique du suPAR a été mesurée chez 1503 patients âgés en moyenne
de 68 ans et recrutés parmi les participants à l’étude SEAS (Simvastatin and Ezetimibe in Aortic Stenosis). Une analyse selon le modèle de régression de Cox a été réalisée afin d’évaluer
les associations entre le suPAR et les paramètres d’évaluation composites regroupant
les événements cardiovasculaires ischémiques, les événements liés à la valve aortique,
la mortalité cardiovasculaire et la mortalité de toutes causes, après ajustement en
fonction des facteurs de risque cardiovasculaire classiques et du traitement attribué.
Résultats
Le rapport des risques instantanés (RRI) multivarié et corrigé (intervalle de confiance
[IC] à 95 %) par unité (log2 ng/ml) d’augmentation du suPAR était de 1,5 (IC à 95
% : 1,2-1,9; p = 0,002) pour les événements cardiovasculaires ischémiques; RRI de 1,2 (IC à 95 %
: 0,9-1,5; p = 0,071) pour les événements liés à la valvule aortique; RRI de 2,0 (IC à 95 % :
1,2-3,3; p = 0,007) pour la mortalité cardiovasculaire; et RRI de 2,0 (IC à 95 % : 1,4-2,9;
p < 0,001) pour la mortalité de toutes causes.
Conclusions
Chez les patients présentant une sténose aortique légère ou modérée, le suPAR est
associé de façon indépendante à l’incidence d’événements cardiovasculaires ischémiques,
de mortalité cardiovasculaire et de mortalité de toutes causes.
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Article info
Publication history
Published online: May 03, 2016
Accepted:
April 25,
2016
Received:
March 21,
2016
Footnotes
See page 1468 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
