title: High osteopontin levels predict long-term outcome after STEMI and primary percutaneous coronary intervention.
abstract: BACKGROUND
  Osteopontin (OPN), a multifunctional glycoprotein, has recently been found to be an important player in cardiovascular diseases and to be implicated in a variety of acute as well as chronic inflammatory processes, including atherosclerosis. This study investigates the association between plasma OPN at admission and the long-term outcome in patients with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI).
  
  
  METHODS
  We included a total of 730 consecutive STEMI patients admitted to a single high-volume invasive heart centre between September 2006 and December 2008. Plasma OPN and high sensitivity C-reactive protein (hsCRP) were measured.
  
  
  RESULTS
  The median follow-up time was 27 months (interquartile range: 22-33) and endpoints were all-cause mortality, re-infarction and heart failure. Even when adjusted for all baseline variables, increasing OPN was independently associated with increased all-cause mortality, and the combined endpoint, a linear increase in OPN of 10 µg/l, was associated with a hazard ratio (HR) of 1.05 (95% confidence interval (CI): 1.02-1.08; p = 0.002) for all-cause mortality and HR 1.03 (95%CI: 1.01-1.05; p = 0.047) for the combined endpoint. Importantly, OPN interacted with the predictive power of hsCRP, and the combination of high OPN levels and high hsCRP levels (>3 mg/l) were significantly associated with increased risk of all-cause mortality (HR: 2.32; CI: 1.51-3.58; p < 0.001), re-infarction (HR: 2.19; CI: 1.22-3.93; p = 0.006), heart failure (HR: 1.84; CI: 1.08-3.13; p = 0.025) and the combined endpoint (HR: 2.08; CI: 1.53-2.84; p < 0.001).
  
  
  CONCLUSIONS
  In conclusion, a high OPN level, especially in combination with a high hsCRP level, was associated with poor long-term outcome in STEMI patients treated with pPCI.
authors.affiliation: The Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Bjerre
authors.forename: Sune H
authors.initials: SH
authors.lastname: Pedersen
authors.forename: Rasmus
authors.initials: R
authors.lastname: Møgelvang
authors.forename: Søren
authors.initials: S
authors.lastname: Lindberg
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
authors.forename: Søren
authors.initials: S
authors.lastname: Galatius
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D003718:Denmark; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D061847:Hospitals, High-Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D053495:Osteopontin / Q000097:blood*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C506895:SPP1 protein, human; D053495:Osteopontin; D002097:C-Reactive Protein
keywords: OPN; Osteopontin; PCI; STEMI; hsCRP