title: Osteoprotegerin and B-type natriuretic peptide in non-ST elevation acute coronary syndromes: relation to coronary artery narrowing and plaques number.
abstract: BACKGROUND
  To analyse osteoprotegerin (OPG), and B-type natriuretic peptide (BNP) levels in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), in relation to clinical presentation and to coronary atherosclerosis diffusion. OPG has been found in several tissues, including the cardiovascular system, BNP is selectively produced by myocardial cells.
  
  
  METHODS
  178 consecutive patients were classified in three groups: stable angina (SA), unstable angina/non-ST elevation myocardial infarction (NSTE-ACS) and control group, measuring OPG and BNP at hospital admission. We compared both biomarkers in relation to the number of coronary narrowed vessels (1-, 2- , 3- or 4- vessels disease), and to the stenoses degree by Duke Jeopardy score.
  
  
  RESULTS
  OPG levels were higher in patients respect to controls (p<0.0001). Patients with SA showed more elevated levels than controls (2.6+/-1.2 vs 7.4+/-5.0 pmol/l p<0.01). However patients with NSTE-ACS had higher OPG level with respect to SA patients (11.8+/-7.1 pmol/l p<0.001). A positive relation was found between OPG levels and number of coronary plaques by Duke Jeopardy score (r=0.65). BNP levels were higher in patients with NSTE-ACS respect to controls and SA patients (p<0.001). Besides, BNP was significantly higher in multivessels vs 1-vessel disease (p<0.001).
  
  
  CONCLUSIONS
  Patients with NSTE-ACS show high OPG levels. OPG increase seems related to the number of plaques in the coronary vessels, suggesting its involvement in the coronary disease progression. BNP is also increased during NSTE-ACS and more associated to coronary narrowing.
authors.affiliation: Department of Internal Medicine and Metabolic Diseases Cardiology Section, University of Siena, S. Maria alle Scotte Hospital, Viale Bracci, Siena, Italy. palazzuoli2@unisi.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Palazzuoli
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rizzello
authors.forename: Anna
authors.initials: A
authors.lastname: Calabrò
authors.forename: Maddalena
authors.initials: M
authors.lastname: Gallotta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martini
authors.forename: Ilaria
authors.initials: I
authors.lastname: Quatrini
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Campagna
authors.forename: Beatrice
authors.initials: B
authors.lastname: Franci
authors.forename: Ranuccio
authors.initials: R
authors.lastname: Nuti
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D053244:Osteoprotegerin / Q000097:blood*
chemical_list: D053244:Osteoprotegerin; D020097:Natriuretic Peptide, Brain