Abstract

Cardiovascular events may occur even after complete revascularization in patients with coronary artery disease. We measured preoperative osteopontin (OPN) levels in 131 consecutive patients (66.5 ± 10 years old, 117 men and 14 women) with left ventricular ejection fraction of 50.7 ± 9.2% and low logistic EuroScore (3.5 ± 3.2%) undergoing elective Coronary Artery Bypass Grafting (CABG) surgery. Patients were prospectively followed up for a median of 12 months (range 11–24). The primary study endpoint was the composite of cardiovascular death, nonfatal myocardial infarction, need for repeat revascularization, and hospitalization for cardiovascular events. Pre-op OPN plasma levels were 77.9 (49.5, 150.9). Patients with prior acute myocardial infarction (AMI) had significantly higher OPN levels compared to those without [131.5 (52.2, 219) versus 73.3 (45.1, 125), p = 0.007]. OPN levels were positively related to EuroScore (r = 0.2, p = 0.031). Pre-op OPN levels did not differ between patients who had a major adverse event during follow-up compared to those with no event (p = 0.209) and had no effect on the hazard of future adverse cardiac events [HR (95% CI): 1.48 (0.43–4.99), p = 0.527]. The history of AMI was associated with increased risk of subsequent cardiovascular events at follow-up (p = 0.02). OPN is associated with preoperative risk assessment prior to low-risk CABG but did not independently predict outcome.

Highlights

  • Osteopontin (OPN) is a matrix cellular protein and cytokine, released when tissue injury and remodeling occur in various organs including the heart [1]

  • There was no difference in OPN levels in relation to age or gender and the prevalence of the examined cardiovascular risk factors (Table 2)

  • We evaluated pre-op OPN levels in patients with stable coronary artery disease (CAD) undergoing elective Coronary Artery Bypass Grafting (CABG) on-pump and found that OPN is higher in patients with prior acute myocardial infarction (AMI) and those on insulin; OPN does not vary in relation to CAD severity or left ventricular ejection fraction but increases with higher EuroSCORES

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Summary

Introduction

Osteopontin (OPN) is a matrix cellular protein and cytokine, released when tissue injury and remodeling occur in various organs including the heart [1]. OPN has been isolated in human aorta, carotid, and coronary arteries and has been shown to be involved in the development and progression of atherosclerosis [2]. OPN may have opposite effects during several cardiovascular diseases [1]. OPN seems to affect prognosis in coronary artery disease (CAD), including acute coronary syndromes (ACS) and chronic stable angina [3, 4], and in heart failure [5]. We sought to investigate whether OPN pre-op has prognostic value for patients following elective Coronary Artery Bypass Grafting (CABG) surgery

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