Increased Urokinase-Type Plasminogen Activator Receptor Expression on Circulating Monocytes Is Correlated with Clinical Instability and Long-Term Adverse Cardiac Events in Patients with Coronary Artery Disease.
OBJECTIVE
This study sought to investigate the clinical correlates and prognostic roles of urokinase-type plasminogen activator receptor (uPAR) on circulating monocytes in patients with coronary artery disease (CAD).


METHODS
263 angina patients were included in this study. The percentage of uPAR expressing monocytes (PUEM) and the mean fluorescence intensity (MFI) index of uPAR were measured using flow cytometry. Patient follow-up was on average 604 days. Major adverse cardiac events (MACE) were defined as a composite of cardiac death, reinfarction, acute heart failure and hospitalization for revascularization.


RESULTS
The PUEM and MFI index levels were significantly more elevated in acute coronary syndrome patients than in stable ones. uPAR expressions on circulating monocytes at admission were correlated to inflammatory biomarkers and myocardial necrosis. Logistic regression analysis revealed that PUEM ≥15% (OR 21.96, 95% CI 7.31-65.98, p < 0.001) and uPAR MFI index ≥3.00 (OR 3.54, 95% CI 1.18-10.59, p = 0.024) were independent determinants of clinical instability in patients with CAD. When followed up, a high PUEM level at admission was an independent prognostic parameter for long-term MACE (HR 3.99, 95% CI 1.31-12.11, p = 0.015).


CONCLUSIONS
uPAR expression on circulating monocytes is associated with clinical instability and myocardial necrosis and independently predicts the risk of MACE in patients with CAD.
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
Yan
Y
Zhang
Wei
W
Chen
Lian-Feng
LF
Chen
Xuan
X
Wang
Jeffrey
J
Hsu
Li-Gang
LG
Fang
Quan
Q
Fang
D000208:Acute Disease; D000368:Aged; D000787:Angina Pectoris; D015415:Biomarkers / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D009203:Myocardial Infarction / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D055293:Receptors, Urokinase Plasminogen Activator / Q000378:metabolism*; D012008:Recurrence
D015415:Biomarkers; D055293:Receptors, Urokinase Plasminogen Activator