Coronary artery calcification and cardiovascular risk: the role of RANKL/OPG signalling.
BACKGROUND
Coronary artery disease (CAD) represents the most relevant cause of death and morbidity in the adult population of developed and developing countries. During the last decades, a strong research effort has been performed to identify more selective markers and better assess the cardiovascular risk in both primary and secondary prevention.


METHODS
This review updates current knowledge regarding the pathophysiological relevance as possible markers of coronary calcification of the receptor activator of nuclear factor-kappa ligand (RANKL)/osteoprotegerin (OPG) system. Furthermore, the potential clinical use of both RANKL/OPG and coronary calcium score (CAC) to assess cardiovascular vulnerability has been discussed.


RESULTS
Emerging evidence indicates that atherosclerotic plaque calcification is positively correlated with vulnerability. Several inflammatory mediators have been shown to modulate arterial calcification, thus increasing the risk of plaque rupture. Among these factors, RANKL/OPG axis might be of particular interest as a promising biomarker of plaque vulnerability in subjects with diffuse coronary calcification.


CONCLUSIONS
Together with clinical parameters of coronary calcification (such as CAC), circulating RANKL/OPG levels could contribute to better assess and predict cardiac events.
Quercioli
Alessandra
A
Division of Cardiology, Department of Medicine, Geneva University Hospital, Foundation for Medical Researches, Geneva, Switzerland.
Montecucco
Fabrizio
F
Bertolotto
Maria
M
Ottonello
Luciano
L
Pende
Aldo
A
Mach
François
F
Dallegri
Franco
F
D015415:Biomarkers / Q000097:blood / Q000378:metabolism*; D002114:Calcinosis / Q000097:blood* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications*; D006801:Humans; D053244:Osteoprotegerin / Q000097:blood* / Q000378:metabolism; D053245:RANK Ligand / Q000097:blood*; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000097:blood*; D012307:Risk Factors
D015415:Biomarkers; D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B