title: Serum osteoprotegerin is a predictor for incident cardiovascular disease and mortality in a general population: the Tromsø Study.
abstract: BACKGROUND
  Osteoprotegerin (OPG) concentration in serum is associated with the presence and severity of atherosclerosis.
  
  
  OBJECTIVE
  To investigate the association between serum osteoprotegerin and the risk of a future myocardial infarction, ischemic stroke and mortality in a general population.
  
  
  METHODS
  OPG was measured in serum collected from 6265 subjects recruited from a general population without a prior myocardial infarction and ischemic stroke (the Tromsø Study). Incident myocardial infarction, ischemic stroke and mortality were registered during follow-up. Cox regression models were used to estimate crude and adjusted hazard ratios and 95% confidence intervals (HR; 95% CI).
  
  
  RESULTS
  There were 575 myocardial infarctions, 284 ischemic strokes and 824 deaths (146 deaths as a result of ischemic heart disease, 78 deaths because of stroke and 600 deaths due to other causes) in the cohort during a median of 10.6 years of follow-up. Serum OPG (per SD [1.13 ng mL(-1)] increase in OPG) was associated with an increased risk of a myocardial infarction (1.20; 1.11-1.31), ischemic stroke (1.32; 1.18-1.47), total mortality (1.34; 1.26-1.42), death because of ischemic heart disease, (1.35; 1.18-1.54), stroke (1.44; 1.19-1.75) and non-vascular causes (1.31; 1.22-1.41) after adjustment for age, gender, current smoking, systolic blood pressure, body mass index, high density lipoprotein cholesterol, total cholesterol, creatinine, high sensitivity C-reactive protein (CRP) and diabetes mellitus or HbA1c > 6.1%. No association was detected between OPG and incident hemorrhagic stroke (1.02; 0.73-1.43).
  
  
  CONCLUSIONS
  Serum OPG was associated with future risk of myocardial infarction, ischemic stroke, total mortality, mortality of ischemic heart disease, stroke and of non-vascular causes independent of traditional cardiovascular risk factors.
authors.affiliation: Center for Atherothrombotic Research in Tromsø (CART), Department of Medicine, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway. anders.vik@uit.no
authors.forename: A
authors.initials: A
authors.lastname: Vik
authors.forename: E B
authors.initials: EB
authors.lastname: Mathiesen
authors.forename: J
authors.initials: J
authors.lastname: Brox
authors.forename: T
authors.initials: T
authors.lastname: Wilsgaard
authors.forename: I
authors.initials: I
authors.lastname: Njølstad
authors.forename: L
authors.initials: L
authors.lastname: Jørgensen
authors.forename: J-B
authors.initials: JB
authors.lastname: Hansen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D053244:Osteoprotegerin / Q000097:blood*
chemical_list: D053244:Osteoprotegerin