Osteoprotegerin concentrations in patients with suspected reversible myocardial ischemia: observations from the Akershus Cardiac Examination (ACE) 1 Study.
Increased circulating osteoprotegerin (OPG) levels have been associated with the prevalence and severity of coronary artery disease and the risk of cardiovascular death. OPG is a cytokine of the tumor necrosis factor receptor superfamily and is expressed in various cell types in the body, including osteoblasts, inflammatory cells, vascular smooth muscle cells/endothelial cells and cardiomyocytes. The main sources determining OPG levels in the circulation however, are not well understood, and whether reversible myocardial ischemia influences OPG levels are not known. Accordingly, OPG levels were measured in 198 patients referred for exercise stress testing and myocardial perfusion imaging (MPI). In addition OPG levels were measured in 8 healthy control subjects performing a maximal bicycle stress test. Plasma samples were collected before, immediately after, 1.5h and 4.5h after exercise stress testing with MPI. OPG levels at baseline were not different in patient with reversible myocardial ischemia (n=19) and patients without reversible ischemia (n=179) (4.7 [3.6-5.5]pmol/L vs. 4.3 [3.4-5.2]pmol/L, p=0.21), and there was an increase in OPG levels immediately after exercise regardless of whether or not the patient had reversible ischemia on MPI (absolute increase: 0.2 [0-0.55]pmol/L vs. 0.3 [0-0.5]pmol/L, p=0.72). OPG levels also increased immediately after stress in the 8 control subjects (3.5 (3.2-3.8)pmol/L at baseline to 3.8 (3.5-4.7), p=0.008). In conclusion, OPG levels increase acutely during exercise stress testing, but this increase is likely caused by mechanisms other than myocardial ischemia.
Division of Medicine, Akershus University Hospital, 1478 Lørenskog, Norway.
Ragnhild
R
Røysland
Division of Medicine, Akershus University Hospital, 1478 Lørenskog, Norway; Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway.
Helge
H
Røsjø
Division of Medicine, Akershus University Hospital, 1478 Lørenskog, Norway; Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway.
Arne Didrik
AD
Høiseth
Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway; Department of Cardiology, Oslo University Hospital, Rikshospitalet, 0372 Oslo, Norway.
Lars
L
Gullestad
Division of Medicine, Akershus University Hospital, 1478 Lørenskog, Norway.
Pirouz
P
Badr
Section for Nuclear Medicine and Section for Medical Biochemistry, Division for Diagnostics and Technology, Akershus University Hospital, 1478 Lørenskog, Norway.
Gunnhild
G
Kravdal
Division of Medicine, Akershus University Hospital, 1478 Lørenskog, Norway; Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway.
Torbjørn
T
Omland
D000328:Adult; D003324:Coronary Artery Disease / Q000097:blood; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood*; D055414:Myocardial Perfusion Imaging; D053244:Osteoprotegerin / Q000097:blood*
D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human
Angina; Exercise stress testing; Myocardial ischemia; Myocardial perfusion imaging; Osteoprotegerin