High Levels of Biomarker suPAR May Predict Risk of Heart Failure, Death

New research suggests that high levels of an immune protein in kidney disease might be able to predict risk of heart failure or death by reflecting the upstream process of stress.

Soluble urokinase plasminogen activator receptor (suPAR) levels may predict heart failure and death, according to a study from Michigan Medicine and the Emory Clinical Cardiovascular Research Institute. SuPAR, an immune protein that impacts kidney disease, levels were found to be high in heart failure patients.

Among patients who did not have heart failure, those with high suPAR levels were 3.5 times more likely to develop heart failure in the future.

SuPAR is “an important component of the pathophysiology of heart failure,” said Salim Hayek, MD, assistant professor of internal medicine and medical director of the University of Michigan Health Frankel Cardiovascular Center clinics, in a press release.

Additionally, the ability to predict heart failure or death was stronger when suPAR was combined with B-type natriuretic peptide (BNP).BNP is a hormone that is considered a gold standard for determining heart failure or risk of death. When cardiac tissue is under pressure, the tissue stretches, and BNP is released. BNP is considered a “downstream” indicator of heart failure, but it does not show what causes heart failure.

Further, SuPAR is suggested to be a more stable biomarker than BNP, explained Hayek—it could serve as a better biomarker for predicting the long-term risk of disease progression or death. To evaluate this biomarker’s efficacy, researchers conducted a study in over 3400 patients whose hearts were scanned over the course of 6 years.

In patients with heart failure, suPAR levels were 17% greater than those in other subgroups. These levels indicated a 2-times greater risk for all-cause death, cardiovascular death, and hospitalization from heart failure.

“We see that suPAR has a major role in cardiovascular disease as a marker of immune activation, which likely reflects an upstream process of stress and inflammation that can cause heart failure,” Hayek said in the press release.

SuPAR has also been found to be associated with poor outcomes for coronary artery disease, cancer, and kidney dysfunction— these diseases have pathways because the immune system is activated on a consistent basis. High suPAR levels are also reflected in this persistent immune activation, Hayek said.

Additionally, while multiple biomarkers can predict long-term heart failure outcomes, Hayek explained further that few have ever shown to be additive to BNP, or sometimes even better than BNP, which is what the results of this study have shown.

“On the practical side, there is a potential for suPAR to be among the biomarkers that we measure to create a strategy for personalizing care for individual patients,” said senior author Arshed Ali Quyyumi, MD, FACC, Director of the Emory Clinical Cardiovascular Institute and professor of medicine in the Division of Cardiology at Emory University School of Medicine, in a press release.

Reference

Immune marker suPAR high in patients with heart failure, predicts risk and death. EurekAlert. October 17, 2022. Accessed on October 17, 2022. https://www.eurekalert.org/news-releases/968009