title: Osteoprotegerin predicts long-term outcome in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.
abstract: BACKGROUND
  Osteoprotegerin (OPG) is a glycoprotein with a regulatory role in immune, skeletal and vascular systems. Data suggest that high circulating OPG levels are associated with an increased risk of cardiovascular disease. We analyzed the association between OPG and long-term outcome in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI).
  
  
  METHODS
  We included 716 consecutive STEMI patients admitted to a single high-volume invasive heart center from September 2006 to December 2008. Endpoints were all-cause mortality, repeat myocardial infarction, admission due to heart failure and combinations thereof. Median follow-up lasted 27 months (interquartile range: 22-33).
  
  
  RESULTS
  OPG levels exhibited a non-Gaussian distribution and were therefore divided into quartiles. High levels of OPG were significantly associated with a worse outcome. After adjustment for conventional risk factors (e.g. C-reactive protein, estimated glomerular filtration rate, symptom-to-balloon time and troponin I) using Cox regression, OPG remained a significantly independent predictor of death (HR per increase in OPG quartile: 1.28; CI: 1.03-1.59; p = 0.03), repeat myocardial infarction (HR: 1.30; CI: 1.00-1.68; p = 0.05) and admission with heart failure (HR: 1.50; CI: 1.18-1.90; p = 0.001).
  
  
  CONCLUSIONS
  This study shows that OPG independently predicts long-term outcome in STEMI patients treated with pPCI. Eventually, this knowledge could improve risk stratification and overall outcome.
authors.affiliation: Department of Cardiology P, Copenhagen University Hospital, Copenhagen, Denmark. peidersen@hotmail.com
authors.forename: Sune
authors.initials: S
authors.lastname: Pedersen
authors.forename: Rasmus
authors.initials: R
authors.lastname: Mogelvang
authors.forename: Mette
authors.initials: M
authors.lastname: Bjerre
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.forename: Soren
authors.initials: S
authors.lastname: Galatius
authors.forename: Tor Biering
authors.initials: TB
authors.lastname: Sørensen
authors.forename: Allan
authors.initials: A
authors.lastname: Iversen
authors.forename: Anders
authors.initials: A
authors.lastname: Hvelplund
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000601:surgery; D053244:Osteoprotegerin / Q000097:blood*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human