Blood biomarker may help physicians accurately identify risk level in heart failure patients

Woodruff Health Sciences Center | Nov. 16, 2016

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NEW ORLEANS – Researchers at Emory University have found that levels of a blood biomarker, suPAR, were considerably elevated in patients with heart failure (HF), regardless of the underlying cause of their disease. Data was presented this week at the American Heart Association Scientific Sessions in New Orleans.

Soluble urokinase plasminogen activator receptor (suPAR), a circulating protein in the blood, is a marker of immune activation, and its levels in blood have been shown to predict renal and heart disease.

The Emory study sought to examine suPAR levels in patients with heart failure to determine whether measuring suPAR would be helpful in predicting outcomes in this high-risk patient group.

Researchers measured suPAR in 5,001 patients participating in the Emory Cardiovascular Biobank, a cohort of patients with cardiovascular disease undergoing cardiac catherizations. The patients were followed for a median of five years for adverse events.

Among 1,503 participants identified with HF, those with a higher level of suPAR had double the risk of mortality and a similarly elevated risk of heart attack or hospitalization for heart failure.

"Not only did we find that suPAR levels were quite elevated in all patients with heart failure, regardless of the cause, but more importantly it was strongly predictive of outcomes. This improves our ability to discriminate risk above and beyond traditional clinical risk factors," says Salim S. Hayek, MD, first author of the study and Emory University cardiology research fellow at the Emory Clinical Cardiovascular Research Institute (ECCRI).

Hayek works with Arshed Quyyumi, MD, senior author of the study and co-director of the ECCRI.

The Emory researchers also compared suPAR to other well established biomarkers such as high sensitivity C-Reactive protein and high sensitivity troponin I. They found that suPAR performed much better than both of these commonly used markers.

"The prevalence of heart failure is increasing, and the burden of overall costs of care for this population is rising exponentially, especially with their high readmission rates," says Quyyumi, professor of medicine (cardiology), Emory University School of Medicine.

"The use of suPAR levels as a measure of risk could potentially allow physicians and health care systems to more accurately identify low- and high-risk patients with heart failure, and perhaps allocate healthcare resources in a more cost-efficient manner and better personalize patient care."

According to Hayek, the association of suPAR with outcomes likely reflects an important pathophysiologic process. These findings should prompt further research to characterize that process and hopefully identify novel treatment targets for both heart failure and other disease states.

Hayek, Quyyumi and their ECCRI colleagues, published a New England Journal of Medicine study last November that showed high levels of suPAR could be an indicator of future kidney disease much like cholesterol and blood pressure levels help predict heart disease.