ArticleDiabetes care2026
Soluble Urokinase Plasminogen Activator Receptor (suPAR) Mediates the Impact of Diabetes on Adverse Outcomes in Coronary Artery Disease.
Article in Diabetes care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- suPAR Identifies Treatment-Resistant Inflammatory Risk Beyond hs-CRP in Type 2 Diabetes With Coronary Artery Disease: An Ancillary Analysis of BARI 2D.Diabetes care · 2026Trial
- Proteomics-Based Soluble Urokinase Plasminogen Activator Receptor Levels Are Associated With Adverse Cardiovascular Outcomes in the General Population: Insights From the UK Biobank.Journal of the American Heart Association · 2026Article
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
objectiveType 2 diabetes (T2D) is a significant risk factor for adverse outcomes in coronary heart disease (CHD). We investigated whether inflammation and immune dysregulation, measured using soluble urokinase plasminogen activator receptor (suPAR) and high-sensitivity C-reactive protein (hs-CRP) levels, mediate this risk. RESEARCH DESIGN AND
methodsPatients with and without CHD enrolled in the Emory Cardiovascular Biobank had suPAR (ViroGates, Denmark) and hs-CRP levels measured and were followed for 1) cardiovascular death, 2) a composite of incident myocardial infarction and cardiovascular death, and 3) all-cause death. Fine and Gray or Cox proportional hazards models adjusted for demographic, clinical, and treatment variables were used. Regression-based causal mediation analyses were performed.
resultsA total of 4,324 participants (mean [SD] age 64 [11.9] years, 36% women, 31.8% with T2D) were followed for a median of 6.9 years. SuPAR levels were higher in those with T2D (median [interquartile range] 3,260 [2,503-4,463] vs. 2,792 [2,217-3,600] pg/mL). T2D was associated with a higher adjusted risk (hazard ratio [HR] 1.38; 95% CI 1.16, 1.63; P < 0.001) of cardiovascular death that was greatly attenuated (HR 1.18; 95% CI 0.99, 1.40; P = 0.1) after adjustment for suPAR, but not hs-CRP, levels. Similar findings were observed for the other outcomes. SuPAR, but not hs-CRP, levels mediated >50% of the effect of T2D on adverse outcomes.
conclusionsThe impact of T2D on adverse outcomes is significantly mediated through chronic inflammation and immune dysregulation, estimated using suPAR levels. Whether novel therapies for reducing suPAR levels will impact CHD risk in T2D warrants further investigation.
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