Circulating Osteoprotegerin Levels and Long-Term Prognosis in Patients With Acute Coronary Syndromes

Abstract

Serum OPG is strongly predictive of long-term mortality and HF development in patients with ACS, independent of conventional risk markers.

Osteoprotegerin Is Associated With Major Bleeding But Not With Cardiovascular Outcomes in Patients With Acute Coronary Syndromes: Insights From the PLATO (Platelet Inhibition and Patient Outcomes) Trial

“…Differences compared with our previous report in 897 patients with ACS, in whom an association between high osteoprotegerin levels at admission and all‐cause mortality was observed, could also be attributable to the markedly longer follow‐up time (89 months) and, thus, a larger proportion and incidence of fatalities 17. Nonetheless, similar to the present study, the relationship between osteoprotegerin and MI was not significant in adjusted analysis 17. Also, in a study by Roysland et al, who evaluated osteoprotegerin in 4463 patients with non‐STE ACS with a similar follow‐up as our study,16 the association with MI was not present in adjusted analysis, although an association with cardiovascular death persisted in adjusted analysis.…”

“…At 1 month, hs‐CRP and, in particular, GDF‐15 were among the strongest predictors of osteoprotegerin; they are more closely related to adverse cardiovascular outcomes in our cohort and could, therefore, partly explain the lack of association with outcomes, compared with other studies that lack GDF‐15 measurements. Differences compared with our previous report in 897 patients with ACS, in whom an association between high osteoprotegerin levels at admission and all‐cause mortality was observed, could also be attributable to the markedly longer follow‐up time (89 months) and, thus, a larger proportion and incidence of fatalities 17. Nonetheless, similar to the present study, the relationship between osteoprotegerin and MI was not significant in adjusted analysis 17.…”

“…Circulating osteoprotegerin has been reported to be associated with cardiovascular outcomes, including mortality, MI, and incident heart failure, in several ACS cohorts 16, 17, 18, 19. However, although most of these studies include natriuretic peptides,16, 17, 19 troponins,16, 17, 18 and CRP16, 17, 18 in their adjustment strategy, none include GDF‐15, which increases in response to myocardial stress associated with inflammation and tissue damage30 and is becoming a recognized biomarker in ACS 9, 10, 14. In this large study population, the association between high osteoprotegerin levels at admission and risk of the primary end point or cardiovascular death was markedly attenuated and no longer significant after addition of NT‐proBNP, hs‐TnT, and GDF‐15 to the model that included clinical variables and inflammatory biomarkers.…”

“…Elevated osteoprotegerin levels have similarly been associated with all‐cause mortality16, 17 and cardiovascular outcomes, like MI18 and heart failure,19 in patients with established coronary artery disease or ACS. In addition to the potential modulatory role of osteoprotegerin on hemostasis through interactions with vWF, elevated circulating osteoprotegerin concentrations have been associated with increased risk of bleeding complications in patients with polycythemia vera,4 a condition with increased risk of both thrombotic and hemorrhagic complications.…”

Polymorphisms in three genes are associated with hemorrhagic stroke

“…Studies showed that OPG was an independent predictor of cardiovascular disease (Nybo and Rasmussen 2008; Omland et al. 2008). The previous study reported that rs2073617 C/C and rs2073618 C/C variant genotypes of the OPG gene were significantly and independently associated with the increased risk of ischemic stroke in an Italian population with diabetic patients (Biscetti et al.…”