Plasma Osteoprotegerin Levels and Long‐Term Prognosis in Patients With Intermediate Coronary Artery Lesions

Abstract

Background: Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily and plays an important regulatory role in the skeletal, immune, and vascular systems. Intermediate coronary artery lesions that have a diameter stenosis of approximately 20%-70% might cause serious consequences. However, the prognostic value of plasma OPG levels in patients with intermediate coronary artery lesions has been less reported. Hypothesis: We hypothesized that OPG is a predictive marker of prognosis of intermediate coronary artery lesions. Methods: A prospective study was performed on 890 patients with intermediate (20%-70%) coronary lesions. The median age was 62 years (25th and 75th percentiles, 55 and 70 years, respectively) and 67.2% were male. Fasting blood was sampled at baseline. The primary clinical endpoint was a composite of readmission due to angina pectoris, nonfatal myocardial infarction, revascularization, and cardiovascular death. Results: During a median follow-up of 24 months, events occurred in 11.1% of the patients. Of these patients, 7.9% were readmitted for angina pectoris, 1.5% received revascularization, 0.7% suffered nonfatal myocardial infarction, and 1.0% died. The plasma levels of OPG (median, 5304.7 pg/mL vs 2993.4 pg/mL, P < 0.001) and high-sensitivity C-reactive protein (median, 4.8 mg/L vs 2.6 mg/L, P < 0.001) were higher in patients with events than those without events. After adjusting for traditional risk factors such as age, gender, smoking, hypertension, diabetes, dyslipidemia, high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, percent area stenosis, and drug administration, a multivariate Cox proportional hazard analysis showed that higher OPG levels were an independent predictive factor of the composite clinical endpoint (hazard ratio: 2.49, 95% confidence interval: 1.26-4.89, fourth quartile vs first quartile). Conclusions: The higher level of OPG is an independent predictive factor of prognosis in patients with intermediate coronary lesions. IntroductionCoronary artery disease (CAD) is associated with increasing cardiovascular morbidity and disability all over the world. Acute coronary syndrome (ACS) is often due to the rupture of plaques with <50% stenosis.

The value of serum osteoprotegerin levels in patients with angina like chest pain undergoing diagnostic coronary angiography

“…Similarly Pederson et al [4] reported increased risk of all-cause mortality, cardiovascular mortality and myocardial infarction with increasing OPG levels among patients with suspected stable angina, but independent effects were mainly confined to OPG levels above the 90 th percentile. Higher OPG level was an independent predictor of poor cardiac prognosis in patients with intermediate coronary lesions [2]. Also serum OPG level was a strong predictive of long-term mortality and HF development in patients with ACS, independent of conventional risk markers [20].…”

“…Osteoprotegerin is expressed in vivo by endothelial cells, vascular smooth muscle cells, and osteoblasts [2]. High serum OPG levels may lead to vascular calcification, formation of atheroscle-rotic plaques, increasing blood pressure, and cardiovascular diseases [3].…”

Macrophage Inflammatory Protein-1β and Fibrinogen Are Synergistic Predictive Markers of Prognosis of Intermediate Coronary Artery Lesions

“…This study and the study by Yang et al [15] were conducted in the same hospitals but not in the same patients.…”

Osteoprotegerin, but not osteopontin, as a potential predictor of vascular calcification in normotensive subjects

“…13 Thus, a synergistic diagnostic strategy (laboratory and imaging study) should be the focus to understand the mechanisms of disease and may be suitable in predicting future events. 38 One further question is whether peripheral vascular function (calcification markers) correlates with CAC, and thus, whether the former may serve as a surrogate marker to identify individuals with coronary endothelial dysfunction. Some limitations of our study merit consideration.…”