title: Elevated plasma osteoprotegerin levels are associated with venous thrombosis and bleeding in patients with polycythemia vera.
abstract: Patients with polycythemia vera (PV) have an increased risk for the development of thrombohemorrhagic complications. The pathogenesis of these complications is still unclear. An important role in vascular disease has recently been attributed to osteoprotegerin (OPG). It has been shown that various tissues of the cardiovascular system produce OPG, and there is growing evidence of an association between elevated serum OPG levels and cardiovascular morbidity. We evaluated if OPG was associated with an increased risk of venous thrombosis or bleeding complications in a cohort of 114 PV patients. The analysis consisted of a retrospective and a prospective part. In the retrospective univariate analysis, a one unit change in OPG caused the odds of venous thrombosis to increase by 40% (p=0.005) and the odds of bleeding to increase by 52% (p=0.001). Multivariate analysis only slightly attenuated the association to 33% (p=0.03) and 37% (p=0.013) for venous thrombosis and bleeding, respectively. OPG was also related to the development of the combined outcome of venous thrombosis and bleeding in the prospective analysis (log-rank-test: p=0.017). This is the first report that links the occurrence of venous thrombosis or bleeding to elevated OPG levels.
authors.affiliation: Medical University Vienna, Department of Internal Medicine I, Division of Hematology and Blood Coagulation, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors.forename: Mathias
authors.initials: M
authors.lastname: Kees
authors.forename: Franz
authors.initials: F
authors.lastname: Wiesbauer
authors.forename: Bettina
authors.initials: B
authors.lastname: Gisslinger
authors.forename: Renate
authors.initials: R
authors.lastname: Wagner
authors.forename: Medhat
authors.initials: M
authors.lastname: Shehata
authors.forename: Heinz
authors.initials: H
authors.lastname: Gisslinger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006470:Hemorrhage / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin; D011087:Polycythemia Vera / Q000097:blood / Q000150:complications*; D011446:Prospective Studies; D018160:Receptors, Cytoplasmic and Nuclear / Q000097:blood*; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood / Q000209:etiology*
chemical_list: D006023:Glycoproteins; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C506030:TNFRSF11B protein, human