title: Plasma osteoprotegerin levels and long-term prognosis in patients with intermediate coronary artery lesions.
abstract: BACKGROUND
  Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily and plays an important regulatory role in the skeletal, immune, and vascular systems. Intermediate coronary artery lesions that have a diameter stenosis of approximately 20%-70% might cause serious consequences. However, the prognostic value of plasma OPG levels in patients with intermediate coronary artery lesions has been less reported.
  
  
  OBJECTIVE
  We hypothesized that OPG is a predictive marker of prognosis of intermediate coronary artery lesions.
  
  
  METHODS
  A prospective study was performed on 890 patients with intermediate (20%-70%) coronary lesions. The median age was 62 years (25th and 75th percentiles, 55 and 70 years, respectively) and 67.2% were male. Fasting blood was sampled at baseline. The primary clinical endpoint was a composite of readmission due to angina pectoris, nonfatal myocardial infarction, revascularization, and cardiovascular death.
  
  
  RESULTS
  During a median follow-up of 24 months, events occurred in 11.1% of the patients. Of these patients, 7.9% were readmitted for angina pectoris, 1.5% received revascularization, 0.7% suffered nonfatal myocardial infarction, and 1.0% died. The plasma levels of OPG (median, 5304.7 pg/mL vs 2993.4 pg/mL, P<0.001) and high-sensitivity C-reactive protein (median, 4.8 mg/L vs 2.6 mg/L, P<0.001) were higher in patients with events than those without events. After adjusting for traditional risk factors such as age, gender, smoking, hypertension, diabetes, dyslipidemia, high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, percent area stenosis, and drug administration, a multivariate Cox proportional hazard analysis showed that higher OPG levels were an independent predictive factor of the composite clinical endpoint (hazard ratio: 2.49, 95% confidence interval: 1.26-4.89, fourth quartile vs first quartile).
  
  
  CONCLUSIONS
  The higher level of OPG is an independent predictive factor of prognosis in patients with intermediate coronary lesions.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Qingmiao
authors.initials: Q
authors.lastname: Yang
authors.forename: Shuzheng
authors.initials: S
authors.lastname: Lu
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
authors.forename: Xiantao
authors.initials: X
authors.lastname: Song
authors.forename: Zening
authors.initials: Z
authors.lastname: Jin
authors.forename: Fei
authors.initials: F
authors.lastname: Yuan
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Yujie
authors.initials: Y
authors.lastname: Zhou
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.forename: Yong
authors.initials: Y
authors.lastname: Huo
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002681:China; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human