title: Soluble urokinase plasminogen activator receptor (suPAR) is a novel, independent predictive marker of myocardial infarction in HIV-1-infected patients: a nested case-control study.
abstract: OBJECTIVE
  Patients infected with HIV are at increased risk of myocardial infarction (MI). Increased plasma levels of the inflammatory biomarker soluble urokinase plasminogen activator receptor (suPAR) have been associated with increased risk of cardiovascular diseases (CVD), including MI in the general population. We tested suPAR as a predictive biomarker of MI in HIV-1-infected individuals.
  
  
  METHODS
  suPAR levels were investigated in a nested case-control study of 55 HIV-1-infected cases with verified first-time MI and 182 HIV-1-infected controls with no known CVD. Controls were matched for age, gender, duration of antiretroviral therapy (ART), smoking and no known CVD. suPAR was measured in the four plasma samples available for each patient at different time-points; 1, Before initiation of ART; 2, 3 months after initiation of ART; 3, 1 year before the case's MI; and 4, The last sample available before the case's MI.
  
  
  RESULTS
  In unadjusted conditional regression analysis, higher levels of suPAR were associated with a significant increase in risk of MI at all time-points. Patients in the third and fourth suPAR quartiles had a three- to 10-fold higher risk of MI compared to patients in the lowest suPAR quartile at all time-points. suPAR remained a strong significant predictor of MI, when adjusting for HIV-1 RNA, total cholesterol, triglycerides and high-density lipoprotein.
  
  
  CONCLUSIONS
  Elevated suPAR levels were associated with increased risk of MI in HIV-infected patients, suggesting that suPAR could be a useful biomarker for prediction of first-time MI in this patient group, even years before the event.
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: L J H
authors.initials: LJ
authors.lastname: Rasmussen
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Knudsen
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
authors.forename: T L
authors.initials: TL
authors.lastname: Katzenstein
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Gerstoft
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Obel
authors.affiliation: Department of Diagnostics and Medicine, Research Centre for Aging and Osteoporosis, Copenhagen University Hospital Glostrup, Glostrup, Denmark.
authors.forename: N R
authors.initials: NR
authors.lastname: Jørgensen
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: G
authors.initials: G
authors.lastname: Kronborg
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Benfield
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Kjaer
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Eugen-Olsen
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: A-M
authors.initials: AM
authors.lastname: Lebech
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000201:enzymology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology*; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood* / Q000235:genetics; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C524898:PLAUR protein, human; D055293:Receptors, Urokinase Plasminogen Activator
keywords: atherosclerosis; biomarker; cardiovascular disease; inflammation; lipids