Summary. Background: Osteoprotegerin (OPG) is a secretory glycoprotein which belongs to the tumor necrosis factor receptor family. OPG immunoreactivity was demonstrated in normal blood vessels and in early atherosclerotic lesions. In a previous study, we showed that high serum OPG levels are associated with progression of coronary artery disease (CAD). Objectives: The present study was designed to assess the association between serum OPG level and long-term prognosis in patients with stable coronary artery disease. Methods: We performed a prospective, observational cohort study in 225 subjects to examine whether serum OPG levels can predict cardiovascular mortality. The median OPG levels were 1.02 ng mL )1 at baseline. Results: During the follow-up (61 ± 25 months), 27 deaths occurred including 13 cardiovascular deaths. When the subjects were divided into three groups according to serum OPG level, the group with high serum OPG showed a higher risk for cardiovascular mortality. A Multivariate Cox proportional hazards model indicated that the higher risk of cardiovascular death in the high OPG level group remained significant (hazards ratio of 7.44, highest vs. lowest OPG tertile). In contrast, serum OPG levels were not associated with non-cardiovascular mortality. Conclusions: Our data show that serum OPG levels are an independent predictor of cardiovascular mortality in patients with stable coronary artery disease.

VLScT may occur at advanced stages of scaffold resorption. Potential mechanisms specific for VLScT include scaffold discontinuity and restenosis during the resorption process, which appear delayed in humans; these findings suggest an extended period of vulnerability for thrombotic events.

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any clinical studies have shown that coronary arteries respond to plaque growth by either outward expansion of the vessel wall (positive remodeling) 1-3 or vessel shrinkage (negative remodeling). 4,5 The difference in plaque morphology between positive and negative remodeling lesions in vivo has been investigated in several clinical studies using intravascular ultrasound (IVUS), but it is difficult to evaluate the detailed plaque composition with gray-scale IVUS.Recently, spectral analysis of IVUS radiofrequency (RF) data was shown to provide detailed quantitative and qualitative information on coronary plaque composition in vivo. [6][7][8][9] A preliminary in vitro study showed that 4 components (eg, fibrous, fibrofatty, dense calcium components, and necrotic core) correlated with a specific spectrum of the RF signal. 10 Nasu et al used a color-coded mapping method by Virtual Histology (VH) that was able to identify atherosclerotic plaque composition of human coronary arteries in vivo. 11 Previous studies using necropsy specimens or gray-scale IVUS have consistently found a large lipid burden in positive remodeling lesions, 12-14 but the role of calcium deposition in coronary artery remodeling is still controversial. 4,[13][14][15][16] In the present study, we used spectral analysis of IVUS RF data to evaluate the relationship between coronary artery remodeling and culprit plaque composition in patients undergoing percutaneous coronary intervention (PCI) in order to confirm the findings of previous studies on lipid burden and to elucidate the role of calcium deposition. Methods Patients and LesionsBetween June 2005 and January 2006, a pre-interventional IVUS examination was performed prospectively in 93 consecutive de novo culprit lesions of 81 patients undergoing PCI; 18 lesions were excluded from analyses because we could not cross the lesion completely with the IVUS transducer; the images of 6 lesions could not be analyzed because of poor image quality; and for 13 lesions, no proximal reference site could be defined because the lesion involved the ostium (n=3) or a bifurcation (n=10). Finally, IVUS RF analyses were performed for 56 culprit lesions of 52 patients.Informed, written consent was given by all the patients. DefinitionsHyperlipidemia was defined as total cholesterol level ≥220 mg/dl, high-density lipoprotein cholesterol level <40 mg/dl, triglyceride level ≥150 mg/dl, low-density lipoprotein (LDL) level ≥140 mg/dl, or/and lipid-lowering medication use. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or/and use of an antihypertensive drug. Diabetes mellitus was defined by a previous physician's diagnosis and treatment with diet, oral hypoglycemic agents, or insulin.Circ J 2007; 71: 654 -660 (Received September 13, 2006; revised manuscript received January 15, 2007; accepted February 9, 2007