(HealthDay News) — Higher levels of soluble urokinase plasminogen activator receptor (suPAR) are associated with incident venous thromboembolism (VTE) among patients hospitalized for COVID-19, regardless of D-dimer levels, according to a study published online Aug. 4 in the Journal of the American Heart Association.
Shengyuan Luo, M.B.B.S., from the Rush University Medical Center in Chicago, and colleagues used a multinational observational study of patients hospitalized with COVID-19 with suPAR and D-dimer levels measured on admission to examine whether suPAR levels identify the risk for VTE. The association between suPAR and incident VTE (defined as pulmonary embolism or deep vein thrombosis) was examined in 1,960 patients.
The researchers found that VTE occurred in 8 percent of patients and was associated with higher suPAR and D-dimer levels. A positive association was seen between suPAR and D-dimer. The odds of VTE were significantly higher comparing the third with the first suPAR tertiles after adjustment for clinical covariables, including D-dimer. When stratified by D-dimer levels and in a survival analysis accounting for death as a competing risk, the findings were consistent. A decision tree revealed that the combined cutoffs of D-dimer <1 mg/L and suPAR <11 ng/mL identified a 3.6 percent probability of VTE during COVID-19 hospitalization; this subgroup accounted for 41 percent of the total study population.
“This finding implies the possible roles of suPAR in COVID-19-related immunothrombosis,” the authors write. “suPAR may be used in conjunction with D-dimer in clinical practice for improved risk stratification of patients with COVID-19 for VTE.”
Several authors disclosed financial ties to the pharmaceutical industry; one author is named an inventor on patents related to suPAR.