suPAR Identifies Treatment-Resistant Inflammatory Risk Beyond hs-CRP in Type 2 Diabetes With Coronary Artery Disease: An Ancillary Analysis of BARI 2D.
Anis Ismail, Yiyuan Huang, Bahjat Ghazzal et al.
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In 30 seconds
This randomized controlled trial analyzed the role of soluble urokinase plasminogen activator receptor (suPAR) in patients with type 2 diabetes and coronary artery disease. Among 2,277 participants, suPAR levels remained unchanged after one year of treatment, while hs-CRP levels decreased significantly. Importantly, suPAR independently predicted cardiovascular events, with an adjusted hazard ratio of 1.40 per SD, highlighting its potential in risk stratification beyond hs-CRP.
Key findings
- suPAR levels did not change significantly across treatment strategies (median 2.96-3.15 ng/mL; P ≥ 0.75).
- suPAR independently predicted composite outcomes with an adjusted HR of 1.40 per SD (95% CI 1.27-1.55).
- Joint classification of suPAR and hs-CRP revealed a threefold gradient in event rates (7.1% to 21.6%).
- In the highest suPAR tertile, insulin provision was linked to worse outcomes (HR 1.33; 95% CI 1.03-1.72).
Why it matters
Understanding the role of suPAR in cardiovascular risk assessment can enhance patient management strategies in those with type 2 diabetes and coronary artery disease, particularly when hs-CRP levels normalize.