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Prognostic value of osteoprotegerin in heart failure after acute myocardial infarction
Thor Ueland1, Rune Jemtland, Kristin Godang
1Research Institute for Internal Medicine, Section of Endocrinology, National University Hospital, Oslo, Norway. thor.ueland@klinmed.uio.no <thor.ueland@klinmed.uio.no>
Insights
Osteoprotegerin (OPG) is a novel marker for cardiovascular mortality in heart failure patients post-acute myocardial infarction. Persistently elevated OPG levels indicate higher risk and aid in patient monitoring.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Bone Metabolism
Background:
- Arterial calcification is linked to atherosclerosis and acute myocardial infarction (AMI).
- Osteoprotegerin (OPG), a novel tumor necrosis superfamily member, may connect skeletal and vascular systems.
- OPG's role in cardiovascular disease warrants investigation.
Purpose of the Study:
- To determine the relationship between osteoprotegerin (OPG) and clinical outcomes in patients with heart failure (HF) following acute myocardial infarction (AMI).
- To assess OPG as a prognostic indicator in this patient population.
Main Methods:
- Plasma OPG levels were measured in 234 patients with AMI and HF at baseline, one month, and one and two years post-event.
- Patients were part of a trial involving angiotensin-converting enzyme inhibition or angiotensin II antagonism.
- Adverse outcomes were tracked during a median 27-month follow-up period.
Main Results:
- Elevated baseline plasma OPG levels were associated with adverse outcomes.
- OPG independently predicted mortality and cardiovascular events, even after adjusting for other risk factors.
- Persistently elevated OPG levels in non-survivors suggest its utility in risk monitoring.
Conclusions:
- Osteoprotegerin is a novel marker for cardiovascular mortality and clinical events in patients with AMI complicated by HF.
- Findings support a potential link between bone homeostasis mediators and cardiovascular disease.
- OPG may serve as a valuable tool for risk stratification and monitoring in post-AMI HF patients.
Objectives:
We sought to determine the relationship between osteoprotegerin (OPG) and clinical outcomes in patients with heart failure (HF) after acute myocardial infarction (AMI).
Background:
Arterial calcification is a prominent feature of arterial atherosclerosis and is associated with the occurrence of AMI. Osteoprotegerin is a recently discovered member of the tumor necrosis superfamily that may link the skeletal with the vascular system.
Methods:
We assayed plasma OPG levels in 234 patients with AMI complicated with HF and their relation to adverse outcomes during follow-up in patients randomly assigned to angiotensin-converting enzyme inhibition or angiotensin II antagonism. Blood was sampled at baseline (median three days after AMI), one month, and at one and two years.
Results:
Elevated plasma levels of OPG at baseline were associated with adverse outcomes during a median of 27 months follow-up; OPG remained an independent prognostic indicator also after adjustment for other known predictors of mortality and cardiovascular events after AMI (e.g., creatinine clearance, N-terminal B-type natriuretic peptide, high-sensitivity C-reactive protein). In non-survivors, plasma OPG levels were persistently elevated during longitudinal testing, suggesting that OPG may be of value for monitoring patients at risk.
Conclusions:
Osteoprotegerin is a novel marker for cardiovascular mortality and clinical events in patients with AMI complicated with HF. These findings are compatible with the hypothesis suggesting a possible association between mediators of bone homeostasis and cardiovascular disease.
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