Coronary disease & ACSCohort study
Soluble urokinase Plasminogen Activator Receptor (suPAR) mediates the effect of a lower education level on adverse outcomes in patients with coronary artery disease
- Prospective cohort study
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 education vs 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
| Outcome | difference (% higher) (95% CI) | P value | |
|---|---|---|---|
| suPAR levels · covariate-adjusted | 9.0 (6.3–11.8) | P ≤ 0.0001 | |
| −5051015Difference, % higher (linear scale) |
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
Summarised from the published abstract; every number is checked against it