Abstract 19287: Circulating Osteoprotegerin Predicts Long-Term Outcome in STEMI-Patients Treated With Primary Percutaneous Coronary Intervention
Background: Osteoprotegerin (OPG) is a glycoprotein with a regulatory role in immune, skeletal and vascular systems. Data suggest that high circulating levels of OPG is associated with increased risk of cardiovascular disease. This study investigates the association between circulating OPG at admission and long-term outcome in STEMI-patients treated with primary percutaneous coronary intervention.
Methods and Results: We included 718 consecutive STEMI-patients admitted to a single high-volume invasive heart center from September 2006 to December 2008. Plasma levels of OPG were collected immediately before the invasive procedure and quantified by commercially available monoclonal antibodies, using a modified Time-Resolved Immunofluorometric Assay (TRIFMA). Primary end-point was all-cause mortality in this observational study. During a median follow-up time of 28 (IQR: 23-33) months, 95 (12%) patients died. OPG-levels did not exhibit normal distribution and were logarithmically transformed using base-2 log. Median OPG level was 2850 (IQR: 1972-3987) ng/L. Per each doubling of OPG, patients had a 97% increased risk of dying (Hazard Ratio: 1.97; Confidence Interval 1.6-2.4; p<0.001). High OPG-levels were significantly associated with increased age and peripheral arterial disease (PAD). After adjustment for relevant conventional baseline variables (age, gender, diabetes, hypertension, hypercholesterolemia, previous MI, PAD, BMI, use of glycoprotein IIb/IIIa-inh, complex lesion and multivessel disease), OPG remained a significantly independent predictor of death, showing an 61% increased risk of dying per each doubling of OPG (Hazard Ratio: 1.61; Confidence Interval 1.3-2.0; p<0.001).
Conclusion: This study shows that OPG independently predicts long-term outcome in STEMI-patients treated with primary percutaneous coronary intervention. Eventually, this knowledge could improve risk stratification, treatment and identify new areas of therapeutic interventions in ischemic patients.
- © 2010 by American Heart Association, Inc.