Serum osteoprotegerin is a predictor for incident cardiovascular disease and mortality in a general population: the Tromsø Study

Abstract

To cite this article: Vik A, Mathiesen EB, Brox J, Wilsgaard T, Njølstad I, Jørgensen L, Hansen J.-B. Serum osteoprotegerin is a predictor for incident cardiovascular disease and mortality in a general population: the Tromsø Study. J Thromb Haemost 2011; 9: 638-44.Summary. Background: Osteoprotegerin (OPG) concentration in serum is associated with the presence and severity of atherosclerosis. Objective: To investigate the association between serum osteoprotegerin and the risk of a future myocardial infarction, ischemic stroke and mortality in a general population. Patients/methods: OPG was measured in serum collected from 6265 subjects recruited from a general population without a prior myocardial infarction and ischemic stroke (the Tromsø Study). Incident myocardial infarction, ischemic stroke and mortality were registered during follow-up. Cox regression models were used to estimate crude and adjusted hazard ratios and 95% confidence intervals (HR; 95% CI). Results: There were 575 myocardial infarctions, 284 ischemic strokes and 824 deaths (146 deaths as a result of ischemic heart disease, 78 deaths because of stroke and 600 deaths due to other causes) in the cohort during a median of 10.6 years of followup. Serum OPG (per SD [1.13 ng mL ] increase in OPG) was associated with an increased risk of a myocardial infarction (1.20; 1.11-1.31), ischemic stroke (1.32; 1.18-1.47), total mortality (1.34; 1.26-1.42), death because of ischemic heart disease, (1.35; 1.18-1.54), stroke (1.44; 1.19-1.75) and nonvascular causes (1.31; 1.22-1.41) after adjustment for age, gender, current smoking, systolic blood pressure, body mass index, high density lipoprotein cholesterol, total cholesterol, creatinine, high sensitivity C-reactive protein (CRP) and diabetes mellitus or HbA1c > 6.1%. No association was detected between OPG and incident hemorrhagic stroke (1.02; 0.73-1.43). Conclusions: Serum OPG was associated with future risk of myocardial infarction, ischemic stroke, total mortality, mortality of ischemic heart disease, stroke and of non-vascular causes independent of traditional cardiovascular risk factors.

Serum osteoprotegerin and future risk of cancer and cancer-related mortality in the general population: the Tromsø study

“…Previously, we observed an association between serum OPG and mortality from non-vascular causes in the general population (HR 1.31, 95% CI 1.22-1.41) (16). Similar risk estimates, although not statistical significant, for mortality from non-vascular events were reported from the Bruneck cohort study including 915 subjects from the general population (19).…”

“…Recently, we reported that serum levels of OPG were associated with mortality of ischemic heart disease, stroke, and non-vascular causes (16). The latter finding may indicate that OPG is also a marker for other diseases as well as cardiovascular disease in the general population.…”

Elevated Osteoprotegerin Predicts Declining Renal Function in Elderly Women: A 10-Year Prospective Cohort Study

“…Therefore, biomarkers such as OPG that independently predict the decline in renal function over time may provide clinical utility for identifying patients with both poorer renal and cardiovascular clinical outcomes. The robust associations observed in our study with OPG and renal function at baseline, long-term renal decline at 5 and 10 years, rapid renal decline and renal disease-related hospitalizations and deaths, provides strong observational evidence that elevated OPG is an independent risk factor for CKD and may help explain the previous observations of others that elevated OPG is associated with CVD [23,25,26]. As a biomarker, OPG has several advantages, such as low intraindividual variation, it is present at relatively high serum levels and the detection is unaffected by freeze-thaw cycles [27].…”

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

“…1). Vik et al [19] followed 6265 subjects recruited from general population with a mean follow-up period of about 10.6 years and they found that increase in OPG level was associated with an increased future risk of myocardial infarction, total mortality, and mortality of ischemic heart disease independent of traditional cardiovascular risk factors. 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.…”