Related Experiment Video
Updated: May 17, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Osteoprotegerin improves risk detection by traditional cardiovascular risk factors and hsCRP
Rasmus Mogelvang1, Sune Haahr-Pedersen, Mette Bjerre
1Department of Cardiology, University of Copenhagen, 2.14.1, Rigshospitalet, Blegdamsvej 9, Copenhagen DK-2100, Denmark. Rasmus.Mogelvang@get2net.dk
Insights
Plasma osteoprotegerin (OPG) independently predicts heart disease, stroke, and mortality. Combining OPG with high-sensitivity C-reactive protein (hsCRP) offers enhanced risk prediction for these cardiovascular events.
Area of Science:
- Cardiovascular Medicine
- Biomarker Research
- Epidemiology
Background:
- Osteoprotegerin (OPG) is implicated in vascular calcification and atherosclerosis.
- High-sensitivity C-reactive protein (hsCRP) is a known marker of inflammation and cardiovascular risk.
Purpose of the Study:
- To assess the association between plasma OPG levels and the risk of ischemic heart disease (IHD), ischemic stroke, and all-cause mortality.
- To determine if combining plasma OPG and hsCRP improves prognostic accuracy.
Main Methods:
- Prospective population-based study (4th Copenhagen City Heart Study) of 5863 adults.
- Measurement of plasma OPG and hsCRP concentrations at baseline.
- Follow-up for a median of 7.8 years to record combined endpoint of IHD, ischemic stroke, or all-cause mortality.
Main Results:
- Elevated plasma OPG was a significant independent predictor of the combined endpoint.
- High concentrations of both OPG and hsCRP were independent predictors.
- The combination of OPG and hsCRP showed a statistically significant interaction, with the highest risk observed when both markers were elevated (HR 5.13).
Conclusions:
- Plasma OPG is an independent risk factor for IHD, ischemic stroke, and all-cause mortality.
- The combined assessment of plasma OPG and hsCRP provides superior prognostic information compared to each biomarker alone.
- This suggests a synergistic role of OPG and inflammation in cardiovascular risk stratification.
Objective:
To evaluate the association of plasma osteoprotegerin (OPG) to hospitalisation for ischaemic heart disease (IHD), ischaemic stroke and all-cause mortality, and the effect of combining plasma OPG and high-sensitivity C-reactive protein (hsCRP).
Design:
OPG and hsCRP concentrations were measured at baseline in a large Danish prospective community-based population study.
Setting:
The 4th Copenhagen City Heart Study.
Participants:
5863 men and women aged 20-95 were recruited from the general population.
Main Outcome Measures:
Combined end-point of IHD, ischaemic stroke or all-cause mortality.
Results:
During a median follow-up of 7.8 years (IQR 7.3-8.3), 1270 subjects (21.7%) reached the combined end-point. A twofold increase in plasma OPG was a significant predictor of the combined end-point (univariable HR 1.85, 95% CI 1.75 to 1.96; p<0.001). In a multivariable Cox-regression model containing age, male sex, hypertension, diabetes, hypercholesterolaemia, present or former smoking, glomerular filtration rate, prior IHD, prior ischaemic stroke, hsCRP and plasma OPG, high concentrations of hsCRP and plasma OPG were independent predictors of the combined end-point. The two biomarkers interacted statistically (p<0.001). Compared to low hsCRP and low OPG (n=1927), either high hsCRP or high OPG (univariable HR 2.38, 95% CI 2.02 to 2.80, p<0.001; n=2816), or both high hsCRP and high OPG (univariable HR 5.13, 95% CI 4.29 to 6.13, p<0.001; n=775) conferred increased risk of the combined end-point.
Conclusions:
OPG is an independent predictor of the combined end-point of hospitalisation of IHD, ischaemic stroke and all-cause mortality. The combination of plasma OPG and hsCRP provides more prognostic information than the individual effect of the two biomarkers.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease IV: Preventive Measures
01:29Pharmacogenomics: Identification of New Drug Targets
01:26Atherosclerosis III: Management