亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Soluble urokinase Plasminogen Activator Receptor (suPAR) mediates the effect of a lower education level on adverse outcomes in patients with coronary artery disease

医学 苏帕 危险系数 内科学 冠状动脉疾病 纤溶酶原激活剂 尿激酶 比例危险模型 纤溶酶原激活物抑制剂-1 置信区间 尿激酶受体 胃肠病学 心脏病学
作者
David Füller,Chang Liu,Yi‐An Ko,Ayman Alkhoder,Shivang Desai,Zakaria Almuwaqqat,Shivani A. Patel,Kiran Ejaz,Tanveer Kauser,Mohamed Afif Martini,Zain Alvi,Puja K. Mehta,Laurence S. Sperling,Arshed A. Quyyumi
出处
期刊:European Journal of Preventive Cardiology [Oxford University Press]
卷期号:31 (5): 521-528 被引量:3
标识
DOI:10.1093/eurjpc/zwad311
摘要

To investigate whether the adverse impact of lower educational attainment on mortality risk in patients with coronary artery disease (CAD) is mediated by the activation of inflammatory and immune pathways, estimated as elevated soluble urokinase plasminogen activator receptor levels.In 3164 patients undergoing coronary angiography, we investigated multivariable associations between suPAR and educational attainment and assessed the relationship between a lower educational level (defined as a high-school degree or less as the highest educational qualification) and outcomes using Cox proportional hazard and Fine and Gray's subdistribution competing risk models. The potential mediating effect through suPAR and high-sensitivity C-reactive protein (hs-CRP) was assessed using mediation analysis. A total of 1814 patients (57.3%) had achieved a higher (≥college) education level and 1350 patients (42.7%) a lower (≤high school) education level. Soluble urokinase plasminogen activator receptor levels were 9.0% [95% confidence interval (CI) 6.3-11.8, P ≤ 0.0001] higher in patients with lower educational qualifications than in those with higher educational qualifications after covariate adjustment. Lower educational attainment was associated with a higher risk of cardiovascular death after adjustment for demographic, clinical, and behavioural covariates, including CAD severity and heart failure history, medication use, and hs-CRP levels [hazard ratio 1.26 (95% CI 1.02-1.55, P = 0.03)]. However, after adjustment for suPAR levels, the effect of a lower educational level on cardiovascular death became insignificant. Values were similar for all-cause death. Soluble urokinase plasminogen activator receptor levels mediated 49% and hs-CRP levels 17% of the cardiovascular death risk attributable to lower educational attainment.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.In patients with coronary artery disease (CAD), we demonstrate that nearly half of the higher risk of all-cause and cardiovascular mortality associated with lower educational attainment as a measure of socioeconomic status is mediated by systemic inflammation and immune dysregulation, which can be estimated by measuring the circulating soluble urokinase plasminogen activator receptor (suPAR) levels. Even after accounting for differences in cardiovascular risk factors, lower educational attainment is associated with higher mortality risk in patients with CAD and there is activation of inflammatory pathways and immune dysregulation in those with lower (≤high school) educational attainment than in those with higher (≥college) educational attainment, estimated as higher circulating suPAR levels.Almost half of the higher risk for adverse outcomes observed in those with lower educational attainment appears to be due to systemic inflammation and immune dysregulation and can be estimated from measuring suPAR levels.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
10秒前
璐璐侠完成签到,获得积分10
15秒前
1分钟前
AJ完成签到 ,获得积分10
1分钟前
xiaozou55完成签到 ,获得积分10
1分钟前
binyao2024完成签到,获得积分10
2分钟前
光亮静槐完成签到 ,获得积分10
2分钟前
lrl350495627发布了新的文献求助10
3分钟前
lrl350495627完成签到,获得积分10
3分钟前
GingerF应助科研通管家采纳,获得50
4分钟前
FashionBoy应助andrele采纳,获得10
4分钟前
4分钟前
自然芷文发布了新的文献求助10
5分钟前
5分钟前
我是老大应助自然芷文采纳,获得10
5分钟前
iNk应助吗喽采纳,获得20
5分钟前
研友_VZG7GZ应助科研通管家采纳,获得10
6分钟前
打打应助科研通管家采纳,获得10
6分钟前
Charlie完成签到 ,获得积分10
6分钟前
CodeCraft应助Benhnhk21采纳,获得30
6分钟前
6分钟前
Benhnhk21发布了新的文献求助30
7分钟前
科研通AI2S应助科研通管家采纳,获得10
7分钟前
村口的帅老头完成签到 ,获得积分0
8分钟前
8分钟前
gincle完成签到 ,获得积分10
8分钟前
8分钟前
andrele发布了新的文献求助10
8分钟前
8分钟前
9分钟前
积极的台灯完成签到,获得积分10
9分钟前
紫荆完成签到,获得积分10
9分钟前
Johnson完成签到 ,获得积分10
9分钟前
李健应助科研通管家采纳,获得10
10分钟前
Benhnhk21发布了新的文献求助10
10分钟前
wanci应助淡然绝山采纳,获得10
10分钟前
10分钟前
wkjfh应助YaoQi采纳,获得10
11分钟前
dyuguo3完成签到 ,获得积分10
11分钟前
高分求助中
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3990181
求助须知:如何正确求助?哪些是违规求助? 3532136
关于积分的说明 11256472
捐赠科研通 3271042
什么是DOI,文献DOI怎么找? 1805190
邀请新用户注册赠送积分活动 882302
科研通“疑难数据库(出版商)”最低求助积分说明 809234