High osteoprotegerin levels predict MACCE in STEMI patients, but are not associated with myocardial salvage

被引:14
作者
Bjerre, Mette [1 ]
Munk, Kim [2 ]
Sloth, Astrid Drivsholm [2 ]
Nielsen, Soren Steen [3 ]
Flyvbjerg, Allan [1 ]
Botker, Hans Erik [2 ]
机构
[1] Aarhus Univ, Fac Hlth, Dept Clin Med, Med Res Lab, DK-8000 Aarhus C, Denmark
[2] Aarhus Univ Hosp, Dept Cardiol, DK-8000 Aarhus C, Denmark
[3] Hosp South West Jutland, Dept Nucl Med, Esbjerg, Denmark
关键词
myocardial salvage index; OPG; STEMI; SERUM OSTEOPROTEGERIN; PLASMA OSTEOPROTEGERIN; CARDIOVASCULAR-DISEASE; INFARCTION; MORTALITY; ANGIOPLASTY; IMPACT; RANKL;
D O I
10.3109/14017431.2014.917767
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. High circulating levels of osteoprotegerin (OPG) carry prognostic impact in cohorts with various cardiovascular diagnoses. With the present study, we aim to investigate the role of OPG within the scale of myocardial damage. Design. This study includes 219 consecutive patients with acute ST-elevation myocardial infarction randomized to primary percutaneous coronary intervention (pPCI) or pPCI and remote ischemic per-conditioning. Salvage index via myocardial single-photon emission CT assessment (data available in 61% of the patients) was performed, and derived from Day 1 (myocardial area at risk) and Day 30 (final infarct size). Plasma OPG levels were measured using an in-house immunoassay. A combined end-point of all-mortality, myocardial infarction, stroke, readmission for heart failure and ischemic stroke/transient ischemic attack (Major Adverse Cardiac and Cerebrovascular Events [MACCE]) was used for follow-up; 45 (38-48 months). Results. High OPG levels were associated with the severity of cardiovascular disease. During follow-up, OPG was a predictor of MACCE (unadjusted, HR: 2.1, 95% CI: 1.14-3.85, P = 0.017). Adjustments for age, gender, and body mass index preserved the independent predictive power of OPG. However, OPG levels were neither associated with salvage index nor with the final infarct size. Remote ischemic per-conditioning had no effect on OPG levels. Conclusion. Despite absent association between OPG levels and the scale of myocardial damage, high OPG levels predict a significantly increased risk of MACCE.
引用
收藏
页码:209 / 215
页数:7
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