Prognostic role of osteoprotegerin and risk of coronary artery calcification: a systematic review and meta-analysis

Plain language summaryThis meta-analysis included published data on the relationship between levels of osteoprotegerin, an important molecule in the bone production process, and the risk of accumulation of calcium deposits in the vessels supplying blood to the heart. Since these calcium deposits are an early sign of heart disease and subsequently heart attacks, understanding the mechanisms and finding ways to treat patients earlier can be of great importance. This study found that the higher the osteoprotegerin level a patient has, the higher the patient's chance of having calcium deposits in his or her heart vessels. Aim: Coronary artery calcification (CAC) is a predictor of atherosclerosis. However, the association of osteoprotegerin (OPG) with CAC is still controversial. Methods: Prospective cohort studies that provided odds ratios with 95% CIs were included from PubMed, Embase, Web of Science and Scopus through July 2022. Results: Out of 14 studies included in the systematic review, three studies with 7642 participants were included in the meta-analysis. The pooled odds ratio indicated a significant association between higher OPG levels and accelerated risk of CAC (1.15; 95% CI: 1.03-1.30; p < 0.001) with relatively no heterogeneity between studies (I-2 = 0%; p = 0.43). Conclusion: The results indicated that increased concentrations of OPG are positively associated with a 15% elevated odds of CAC after adjustment of major covariates.