Serum osteoprotegerin levels and long-term prognosis in patients with stable angina pectoris.
OBJECTIVE
Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily with pleiotropic effects on bone metabolism, endocrine function and the immune system. Circulating OPG levels are elevated in cardiovascular disease (CVD). We assessed serum OPG as predictor of long-term prognosis in patients with suspected stable angina pectoris (SAP) undergoing elective coronary angiography.


METHODS
Samples were obtained from 1025 patients (median [25th, 75th percentile] age 62 [54, 70] years, 71.9% men). At inclusion, 43.2% of patients had single or double vessel disease, whereas 34.3% had triple vessel disease.


RESULTS
During a median follow-up of 73 months, 11.0% of patients died, 5.9% died from CVD and 10.0% experienced an acute myocardial infarction (MI). In univariable analyses, strong associations were observed between OPG concentrations and all-cause mortality, CVD mortality and the incidence of MI (fatal or nonfatal). However, adjustment for conventional risk factors attenuated the risk estimates which were no longer significant, except for the subgroup with levels above the 90th percentile. For decile 10 versus deciles 1-9 of serum OPG, the following multivariable hazard ratios (95% confidence intervals) were observed: All-cause mortality: 1.94 (1.18, 3.18), p=0.01; CVD mortality: 2.29 (1.16, 4.49), p=0.02; and MI: 1.76 (1.02, 3.06), p=0.04.


CONCLUSIONS
In patients with SAP, elevated serum OPG is associated with increased risk of all-cause mortality, CVD mortality and MI, but independent effects are mainly confined to levels above the 90th percentile.
Pedersen
Eva Ringdal
ER
Institute of Medicine, University of Bergen, 5021 Bergen, Norway. evpe@helse-bergen.no
Ueland
Thor
T
Seifert
Reinhard
R
Aukrust
Pål
P
Schartum-Hansen
Hall
H
Ebbing
Marta
M
Bleie
Øyvind
Ø
Igland
Jannicke
J
Svingen
Gard
G
Nordrehaug
Jan Erik
JE
Nygård
Ottar
O
D000368:Aged; D000787:Angina Pectoris / Q000097:blood*; D000792:Angiography / Q000379:methods; D002318:Cardiovascular Diseases / Q000097:blood; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood; D053244:Osteoprotegerin / Q000097:blood*; D011379:Prognosis; D012307:Risk Factors
D053244:Osteoprotegerin