title: Osteopontin plasma levels and accelerated atherosclerosis in patients with CAD undergoing PCI: a prospective clinical study.
abstract: OBJECTIVE
  Growing evidence supports the role played by inflammation in atherosclerosis. Identifying sensitive biomarkers is useful in predicting accelerated atherosclerosis. We investigated prospectively the relationship between plasma levels of inflammatory biomarkers [osteopontin, C-reactive protein (CRP), interleukin-6 (IL-6)] and instent restenosis, and rapid coronary plaque progression in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).
  
  
  METHODS
  We studied 77 patients with CAD: 45 affected by unstable angina/non-ST elevation myocardial infarction [acute coronary syndrome (ACS)], and 32 by chronic coronary syndrome (CCS). Plasma osteopontin, IL-6, and CRP levels were measured before intervention in all patients; measurements were carried out on the basis of the following time course at 1,15, 30, 90, and 180 days follow-up in a subgroup of 39 consenting patients. Clinical and biohumoral data were correlated with baseline and 6-month PCI follow-up angiography.
  
  
  RESULTS
  Osteopontin, IL-6, and CRP were higher in patients with ACS than in those with CCS (analysis of variance: P<0.001, 0.05, and 0.05, respectively). Baseline osteopontin levels proved to be associated with rapid coronary plaque progression (P=0.005) and instent restenosis (P=0.05). The highest osteopontin levels were found in patients with CAD with both rapid plaque progression and instent restenosis (P=0.003). PCI increased inflammatory markers acutely, and osteopontin remained elevated in patients with ACS. Patients with ACS showed a higher percentage (74%) of rapid plaque progression than those with CCS (26%) (P<0.05).
  
  
  CONCLUSIONS
  The study prospectively shows the link between inflammatory status and accelerated atherosclerosis in patients with CAD undergoing PCI. The baseline and persistent rise of osteopontin is an expression of its contribution to the accelerated plaque progression, and therefore osteopontin may be a useful prognostic biomarker.
authors.affiliation: Department of Cardiology, Heart Hospital, Fondazione Toscana G. Monasterio/CNR, Massa, Italy. mazzone@ifc.cnr.it
authors.forename: Annamaria
authors.initials: A
authors.lastname: Mazzone
authors.forename: Maria Serena
authors.initials: MS
authors.lastname: Parri
authors.forename: Daniela
authors.initials: D
authors.lastname: Giannessi
authors.forename: Marcello
authors.initials: M
authors.lastname: Ravani
authors.forename: Marco
authors.initials: M
authors.lastname: Vaghetti
authors.forename: Paola
authors.initials: P
authors.lastname: Altieri
authors.forename: Laura
authors.initials: L
authors.lastname: Casalino
authors.forename: Maristella
authors.initials: M
authors.lastname: Maltinti
authors.forename: Manrico
authors.initials: M
authors.lastname: Balbi
authors.forename: Antonio
authors.initials: A
authors.lastname: Barsotti
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D053495:Osteopontin / Q000097:blood*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D053495:Osteopontin