Coronary disease & ACS

Soluble urokinase Plasminogen Activator Receptor (suPAR) mediates the effect of a lower education level on adverse outcomes in patients with coronary artery disease

Eur J Prev CardiolPublished Prospective cohort study

Main finding · CV deathResult — go to the resultHazard ratio 1.26 95% CI 1.02–1.55

Authors' conclusion

Circulating suPAR levels importantly mediate the effects of lower educational attainment on mortality, indicating the importance of systemic inflammation and immune dysregulation as biologic mediators of adverse social determinants of health.

Study context

Population
Patients undergoing coronary angiography (coronary artery disease (CAD))
Participants
3,164 patients
Exposure
Lower vs higher education level
  • Lower educationn = 1,350
  • Higher educationn = 1,814reference
Outcome
CV death; mediation by suPAR and hs-CRP

Main finding

CV death

Hazard ratio

1.26

95% CI 1.02–1.55

P = 0.03

Lower educationvs Higher education
HR 1.26 (95% CI 1.02–1.55); P = 0.03

As reported in the abstract

Proportion of CV death risk mediated by suPAR
49%
Proportion of CV death risk mediated by high-sensitivity C-reactive protein (hs-CRP)
17%

Observational data: associations, not effects.

Further findings

OutcomeDifference (% higher) (95% CI)P value
suPAR levelsCovariate-adjusted9.0 (6.3–11.8)P ≤ 0.0001

All-cause death

Values similar to CV death

Original publication

Soluble urokinase Plasminogen Activator Receptor (suPAR) mediates the effect of a lower education level on adverse outcomes in patients with coronary artery disease. Eur J Prev Cardiol. Published 3 October 2023. doi:10.1093/eurjpc/zwad311

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