Int J Cardiol. 2026 Jan 29:134199. doi: 10.1016/j.ijcard.2026.134199. Online ahead of print.
ABSTRACT
BACKGROUND: The inflammatory biomarker, soluble urokinase plasminogen activator receptor (suPAR), has emerged as a promising prognostic biomarker in cardiovascular diseases. Currently little is known about suPAR-values in patients admitted with acute heart failure (AHF). This study investigates the prevalence and prognostic value of elevated suPAR in patients hospitalized with AHF.
METHODS: This cohort study included patients presenting with COVID-19 symptoms at the Medical Emergency Department of University Hospital Amager-Hvidovre, Denmark, between March 10, 2020, and March 31, 2022. SuPAR was measured in all patients upon admission, with the median time from admission to suPAR measurement was two hours (IQR 3.9-6.9)). A cardiologist adjudicated whether the patients had AHF. Patients were stratified according to validated cut-off values of suPAR <6 ng/mL and ≥ 6 ng/mL. Kaplan-Meier survival analysis and Cox regression were used to assess the association between suPAR levels and one-year mortality outcomes.
RESULTS: A total of 386 (3.8%) AHF patients, from a total population of 10,027, were included. The mean suPAR value was significantly higher among AHF patients compared to non-AHF patients: 6.2 ng/mL (standard deviation [SD] = 4.8 ng/mL) vs 4.4 ng/mL (SD = 2.9 ng/mL), p < 0.001. A suPAR level ≥ 6 ng/mL was significantly associated with mortality, log-rank-p-value <0.0001. Furthermore, Cox regression analysis demonstrated that elevated suPAR levels were independently associated with increased risk of mortality with a hazard ratio (HR): 1.06 (95% CI: 1.03-1.1, p < 0.001) after adjusting for potential confounders.
CONCLUSION: SuPAR levels measured at hospital admission in AHF patients correlate significantly with one-year mortality risk. Potentially, suPAR could be integrated as a part of an early multimodal prognostication mode of AHF to identify high-risk patients.
PMID:41619858 | DOI:10.1016/j.ijcard.2026.134199