A cut-off value of plasma osteoprotegerin level may predict the presence of coronary artery calcifications in chronic kidney disease patients

Moréna, Marion; Dupuy, Anne‐Marie; Jaussent, Isabelle; Vernhet, Hélène; Gahide, G.; Klouche, Kada; Bargnoux, Anne-Sophie; Delcourt, Cécile; Canaud, Bernard; Cristol, Jean‐Paul

doi:10.1093/ndt/gfp301

Cited by 61 publications

(76 citation statements)

References 48 publications

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“…Similar findings have been reported also in other cross-sectional and observational studies on HD patients (14,15). Additionally, the work by Moreno et al (16) showed that, among all risk factors examined, serum OPG level is the strongest predictor of CAC, and values of OPG.757.7 pg/ml (equivalent to 6.31 pmol/L) may predict the presence of CAC in CKD patients. Prospective and longitudinal studies investigating the effects of OPG/ RANKL axis on the progression of VC are scarce in the literature.…”

Section: Discussionsupporting

confidence: 85%

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Osteoprotegerin/RANKL Axis and Progression of Coronary Artery Calcification in Hemodialysis Patients

Özkök

Çalışkan

Tamer

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Vascular calcification is associated with increased cardiovascular mortality in chronic hemodialysis patients. This prospective study investigated the relationship between serum osteoprotegerin, receptor activator of NF-kB ligand, inflammatory markers, and progression of coronary artery calcification score.Design, setting, participants, & measurements Seventy-eight hemodialysis patients were enrolled. Serum IL-1b, IL-6, TNF-a, osteoprotegerin, receptor activator of NF-kB, fetuin A, and bone alkaline phosphatase were measured by ELISA. Coronary artery calcification score was measured two times with 1-year intervals, and patients were classified as progressive or nonprogressive.Results Baseline and first-year serum osteoprotegerin levels were significantly higher in the progressive than nonprogressive group (17.3969.67 versus 12.9066.59 pmol/L, P=0.02; 35.17618.35 versus 24611.65 pmol/L, P=0.002, respectively). The ratio of serum osteoprotegerin to receptor activator of NF-kB ligand at 1 year was significantly higher in the progressive group (0.26 [0.15-0.46] versus 0.18 [0.12-0.28], P=0.004). Serum osteoprotegerin levels were significantly correlated with coronary artery calcification score at both baseline (r=0.36, P=0.001) and 1 year (r=0.36, P=0.001). Importantly, progression in coronary artery calcification score significantly correlated with change in serum osteoprotegerin levels (r=0.39, P=0.001). In addition, serum receptor activator of NF-kB ligand levels were significantly inversely correlated with coronary artery calcification scores at both baseline (r=20.29, P=0.01) and 1 year (r=20.29, P=0.001). In linear regression analysis for predicting coronary artery calcification score progression, only baseline coronary artery calcification score and change in osteoprotegerin were retained as significant factors in the model. ConclusionsBaseline coronary artery calcification score and serum osteoprotegerin levels were significantly associated with progression of coronary artery calcification score in hemodialysis patients.

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Section: Discussionsupporting

confidence: 85%

“…In cross-sectional observational studies, it was reported that high-serum OPG levels were associated with increased coronary artery calcification score (CACS) in patients with CKD (14)(15)(16). In two similar studies performed on renal transplant recipients, findings suggested a possible role of serum OPG on the progression of VC (17,18).…”

Section: Introductionmentioning

confidence: 98%

Osteoprotegerin/RANKL Axis and Progression of Coronary Artery Calcification in Hemodialysis Patients

Özkök

Çalışkan

Tamer

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…In contrast to our study, the AUC for CAC identification was 0.574 for fetuin A. In a study concerning CKD patients, osteoprotegerin had an AUC of 0.79 and neither of calcium phosphate disorder markers had similar ability (Morena et al 2009). …”

Section: Discussioncontrasting

confidence: 98%

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation

Simić-Ogrizović¹,

Bogavac-Stanojević

Vuckovic

et al. 2012

Tohoku J. Exp. Med.

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The best treatment for end stage renal disease (ESRD) patients is kidney transplantation, but the renal transplant recipients still have a higher incidence of cardiovascular events compared with general population. Cardiovascular risk factors were imposed long before ESRD, as the majority of patients starting dialysis or kidney transplantation already have signs of advanced atherosclerosis. Artery calcification is an organized, regulated process similar to bone formation. Coronary artery calcification (CAC) is found frequently in advanced atherosclerotic lesions and could be a useful marker of them. We evaluated the prevalence of CAC in 49 stable renal transplant recipients and in 48 age-and gender-matched patients with chronic kidney disease (CKD) in stages 2-5 not requiring dialysis to assess risk factors associated with CAC. Computed tomography was used for CAC detection and quantification (CAC score). The prevalence of CAC was 43.8% in transplant recipients and 16.7% in CKD patients (p < 0.001). Transplant recipients with CAC were significantly older and had longer duration of CKD and/or dialysis than recipients without CAC. In contrast, the serum levels of fetuin A (an inhibitor of vascular calcification) and albumin were significantly lower in CKD patients with CAC than those without CAC. During the observation period (30 months), 30 patients, including 23 CKD patients, began dialysis, and 4 transplant recipients and 2 CKD patients died. Independent predictors of mortality were age, serum amyloid A and the CAC score. In conclusion, the examination and prevention of risk factors associated with atherosclerosis should be started at the beginning of renal failure.

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“…The relation between coronary atherosclerosis and OPG has also been demonstrated in recent studies [4,18]. If atherosclerotic calcification fails, it can cause the vessels to break as a result of plaque rupture [4,19].…”

Section: Discussionmentioning

confidence: 72%

“…Also, we found a cutoff level of OPG in CAD. Morena et al [18] reported that the cutoff level of OPG was best able to predict the presence of significant CAD. But, the cutoff level of OPG could act as a predictor in CAD patients, since this attribute was found in chronic kidney disease patients.…”

Section: Discussionmentioning

confidence: 99%

The relation between the levels of osteoprotegerin and the degree of coronary artery disease in patients with acute coronary syndrome and stable angina pectoris

Aksu

Özçeli̇k²,

Kunduracilar³

et al. 2014

Kardiol Pol

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A b s t r a c tBackground: Osteoprotegerin (OPG), an inhibitor of osteoclastogenesis, has recently been under the spotlight in studies regarding the pathophysiology of atherosclerosis. Aim:To evaluate the value of serum OPG in the diagnosis and severity in patients with stable angina pectoris (SA) and unstable angina pectoris/non ST elevation myocardial infarction. Methods:This study involved 160 patients, SA (n = 65), acute coronary syndrome (NSTE-ACS; n = 65), and a control group (n = 30). Blood samples were collected in the first hour, after 24 hours and on the fifth day. The prevalence of coronary artery atherosclerotic lesions was determined using the Gensini scoring system.Results: A statistically significant difference was observed in the first hour OPG levels between the control group and both the SA and NSTE-ACS group (p < 0.001). When the cut-off value was determined as 247.71 pg/mL, the sensitivity and specifi city of the first hour OPG levels indicating coronary artery disease were 91.54% and 46.67%, respectively, while the positive predictive value was 88.1% and the negative predictive value was 56%. No correlations were observed between the first, 24 th hour and the fifth day OPG levels and the Gensini scores. No relation was denoted between the OPG levels and number of diseased coronary arteries. Conclusions:In our study, serum OPG level seemed to be unrelated to the severity or the degree of coronary artery disease in patients with SA and unstable angina pectoris/non ST elevation myocardial infarction. OPG may only be accepted as an indicator of coronary artherosclerosis. Copyright © Polskie Towarzystwo Kardiologiczne INTRODUCTION Coronary atherosclerosis is the most common form of cardiovascular disease, with high mortality and morbidity rates. Arterial calcification has been found to be related to an increased risk of cardiovascular events, although the predictive value of coronary risk factors remains unclear [1].

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A cut-off value of plasma osteoprotegerin level may predict the presence of coronary artery calcifications in chronic kidney disease patients

Abstract: These results suggest that a CAC increase is strongly associated with a plasma OPG increase in CKD patients. The values of OPG >757.7 pg/mL allow us to predict the presence of CAC in these patients.

Cited by 61 publications

References 48 publications

Osteoprotegerin/RANKL Axis and Progression of Coronary Artery Calcification in Hemodialysis Patients

Osteoprotegerin/RANKL Axis and Progression of Coronary Artery Calcification in Hemodialysis Patients

Risk Factors Associated with Coronary Artery Calcification Should Be Examined before Kidney Transplantation

The relation between the levels of osteoprotegerin and the degree of coronary artery disease in patients with acute coronary syndrome and stable angina pectoris

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