Plasma osteoprotegerin levels and long-term prognosis in patients with intermediate coronary artery lesions

Background:

Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily and plays an important regulatory role in the skeletal, immune, and vascular systems. Intermediate coronary artery lesions that have a diameter stenosis of approximately 20%–70% might cause serious consequences. However, the prognostic value of plasma OPG levels in patients with intermediate coronary artery lesions has been less reported.

Hypothesis:

We hypothesized that OPG is a predictive marker of prognosis of intermediate coronary artery lesions.

Methods:

A prospective study was performed on 890 patients with intermediate (20%–70%) coronary lesions. The median age was 62 years (25th and 75th percentiles, 55 and 70 years, respectively) and 67.2% were male. Fasting blood was sampled at baseline. The primary clinical endpoint was a composite of readmission due to angina pectoris, nonfatal myocardial infarction, revascularization, and cardiovascular death.

Results:

During a median follow‐up of 24 months, events occurred in 11.1% of the patients. Of these patients, 7.9% were readmitted for angina pectoris, 1.5% received revascularization, 0.7% suffered nonfatal myocardial infarction, and 1.0% died. The plasma levels of OPG (median, 5304.7 pg/mL vs 2993.4 pg/mL, P<0.001) and high‐sensitivity C‐reactive protein (median, 4.8 mg/L vs 2.6 mg/L, P<0.001) were higher in patients with events than those without events. After adjusting for traditional risk factors such as age, gender, smoking, hypertension, diabetes, dyslipidemia, high‐density lipoprotein cholesterol, high‐sensitivity C‐reactive protein, percent area stenosis, and drug administration, a multivariate Cox proportional hazard analysis showed that higher OPG levels were an independent predictive factor of the composite clinical endpoint (hazard ratio: 2.49, 95% confidence interval: 1.26–4.89, fourth quartile vs first quartile).

Conclusions:

The higher level of OPG is an independent predictive factor of prognosis in patients with intermediate coronary lesions. © 2011 Wiley Periodicals, Inc. This study was funded by Beijing Municipal Science and Technology Committee (No. D0906006000091). The authors have no other funding, financial relationships, or conflicts of interest to disclose.