Circulating Osteoprotegerin Levels and Long-Term Prognosis in Patients With Acute Coronary Syndromes
| Autor: | Camilla Smith, Johan Herlitz, Pål Aukrust, Torbjørn Omland, Anita Persson, Marianne Hartford, Thor Ueland, Anna Jansson, Kenneth Caidahl, Thomas Karlsson |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Male
musculoskeletal diseases Acute coronary syndrome medicine.medical_specialty Time Factors Endocrine System Gastroenterology Bone and Bones Angina Osteoprotegerin Internal medicine medicine Humans Angina Unstable Prospective Studies Myocardial infarction Acute Coronary Syndrome Stroke Aged Ejection fraction business.industry Incidence Hazard ratio Middle Aged Prognosis medicine.disease Hospitalization Endocrinology Immune System Heart failure Female Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Journal of the American College of Cardiology. 51:627-633 |
| ISSN: | 0735-1097 |
| Popis: | ObjectivesThis study was designed to assess the association between osteoprotegerin (OPG) levels on admission and long-term prognosis in patients with acute coronary syndromes (ACS).BackgroundOsteoprotegerin, a member of the tumor necrosis factor receptor superfamily, has pleiotropic effects on bone metabolism, endocrine function, and the immune system.MethodsSerum samples for OPG analysis were obtained within 24 h of admission in 897 ACS patients (median age 66 years, 71% men) and related to the incidence of death, heart failure (HF) hospitalizations, myocardial infarction (MI), and stroke.ResultsA total of 261 patients died during a median follow-up of 89 months. The baseline OPG concentration was strongly associated with increased long-term mortality (hazard ratio [HR] for HR per 1 SD increase in logarithmically transformed OPG level 1.7 [range 1.5 to 1.9] p < 0.0001) and HF hospitalizations (HR 2.0 [range 1.6 to 2.5]; p < 0.0001) but weaker with recurrent MI (HR 1.3 [range 1.0 to 1.5]; p = 0.02) and not with stroke (HR 1.2 [range 0.9 to 1.6]; p = 0.35). After adjustment for conventional risk markers, including troponin I, C-reactive protein (CRP), B-type natriuretic peptide (BNP), and ejection fraction, the association remained significant for mortality (HR 1.4 [range 1.2 to 1.7]; p < 0.0001) and HF hospitalization (HR 1.6 [range 1.2 to 2.1]; p = 0.0002), but not recurrent MI. By comparison of the area under the receiver-operating characteristics curves, OPG performed similarly to BNP and ejection fraction and significantly better than CRP and troponin I as a predictor of death.ConclusionsSerum OPG is strongly predictive of long-term mortality and HF development in patients with ACS, independent of conventional risk markers. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|