Intermediate coronary lesions: prognostic evaluation of plasma osteoprotegerin in elderly patients

Abstract

Objective To investigate the evaluation of plasma osteoprotegerin(OPG)measurement for assessing the prognosis of intermediate coronary lesions in elderly patients. Methods We retrospectively analyzed patients met the inclusion criteria of suspicious chest pain or confirmed coronary artery disease(CHD), and intermediate stenosis lesions(20%~70%)in 3 main coronary arteries served as target vessels for qualitative comparative analysis(QCA). Plasma OPG level was detected by protein array method, and the concentration of hypersensitive C-reactive protein(hs-CRP)was determined by enzyme-linked immunosorbent assay(ELISA). Clinical endpoints were followed up. Results A total of 890 patients with intermediate coronary stenosis were enrolled in this study, and were divided into<60 years of age group(n=370)and ≥ 60 years of age group(n=520). There were statistical differences in age, smoking history, hypertension history, triglycerides(TG), high-density lipoprotein cholesterol(HDL-C), white blood cell count, OPG, systolic blood pressure(SBP), diastolic blood pressure(DBP), body mass index(BMI)between the two groups. The morphological indices in coronary lesions assessed by QCA had no differences between the two groups. During a median of 24 months of follow-up, 58 patients(11.2%)had clinical endpoints events. Age, smoking history, hypertension history, TC, TG, HDL-C, white blood cell count, levels of OPG above-median, hs-CRP, SBP, DBP, and BMI were used as the independent variables, and the clinical end events as the dependent variable. Forward stepwise logistic regression analysis showed that HDL-C, levels of OPG above-median, hs-CRP were the independent risk factors in elderly patients. The risk of cardiovascular events in patients with levels of OPG above-median was 2.510 fold higher than those with levels of OPG below-median. Conclusions The high levels of OPG and hs-CRP are the independent risk factors for the occurrence of coronary heart disease in the elderly with intermediate coronary lesions. Key words: Atherosclerosis; Osteoprotegerin; Coronary artery disease