Initially elevated osteoprotegerin serum levels may predict a perioperative myocardial lesion in patients undergoing coronary artery bypass grafting.
OBJECTIVE
We investigated whether osteoprotegerin (OPG), an important regulator in the genesis of arteriosclerosis and bone formation, is able to identify patients at risk for perioperative myocardial infarction measured as cardiac troponin I (cTNI) and signs of myocardial ischemia in the electrocardiogram after coronary artery bypass grafting (CABG).


METHODS
Observational study.


METHODS
Post-surgical intensive care unit of a tertiary care center.


METHODS
Ninety-seven patients undergoing elective CABG.


METHODS
None.


RESULTS
OPG and cTNI were measured before and 24 hrs after CABG. Additionally, cTNI was measured after 12 hrs. Electrocardiography was done before and immediately after CABG. OPG before CABG (OPGpre) measurements correlated with cTNI measurements after 12 hrs (cTNI12) (r = 0.56; p < .0001) and with cTNI measurements after 24 hrs (cTNI24) (r = 0.77; p < .0001). OPGpre measurements correlated with electrocardiographic findings after surgery (r = 0.65; p < .0001). There was a positive correlation between OPGpre value and the number of bypasses (r = 0.95; p < .0001). A strong correlation was found between OPGpre and homocysteine (r = 0.96; p < .0001). The median OPG presurgical level for the four patients with cardiac complications was found to be notably elevated (28.1 [26.6/31.0] pmol/L) in comparison with that for patients without complications (10.2 [3.7/16.9] pmol/L).


CONCLUSIONS
OPG appears to be a useful marker for estimating risk for perioperative myocardial infarction in patients undergoing CABG, as demonstrated by signs of ischemia on electrocardiography.
Hermann-Arnhof
K M
KM
Department for Clinical and Chemical Laboratory-Diagnostic, Hospital Lainz, Austria.
Kästenbauer
T
T
Publig
T
T
Novotny
P
P
Loho
N
N
Schwarz
S
S
Köller
U
U
Fitzgerald
R
R
D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D016001:Confidence Intervals; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006023:Glycoproteins / Q000097:blood* / Q000378:metabolism; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011859:Radiography; D018160:Receptors, Cytoplasmic and Nuclear / Q000097:blood* / Q000378:metabolism; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood* / Q000378:metabolism; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
D015415:Biomarkers; D006023:Glycoproteins; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C506030:TNFRSF11B protein, human