SERUM SCLEROSTIN AND ADVERSE OUTCOMES IN ELDERLY PATIENTS WITH STABLE CORONARY ARTERY DISEASE UNDERGOING PERCUTANEOUS CORONARY INTERVENTION

Abstract

Recently, sclerostin, a bone-derived protein, has been shown to play a key role in the progression of atherosclerosis. However, few studies have investigated the influence of sclerostin on the prognosis of cardiovascular disease. We investigated the relationship between serum sclerostin levels and adverse outcomes in elderly patients with stable coronary artery disease (SCAD) who are undergoing percutaneous coronary intervention (PCI). A total of 310 elderly SCAD patients who underwent PCI were enrolled in this study, with a follow-up of 3 years. According to the median serum sclerostin levels, subjects were stratified into a low sclerostin (low scl) group (n=144) and a high sclerostin (high scl) group (n=166). Time-to-event analyses were performed by the Kaplan-Meier method. The associations between sclerostin levels and main the adverse cardiovascular and cerebrovascular events (MACCEs) and mortality were evaluated by Cox multivariate regression analysis. Kaplan-Meier curves showed that the high scl group had a significantly higher MACCE-free rate (log rank p < 0.001) and better survival (log rank both p < 0.05) than the low scl group did. Serum sclerostin was an independent predictor of MACCEs and all-cause mortality. In addition, serum sclerostin levels were significantly associated with N-MID (β=-0.357, p < 0.001), β-CTX (β=0.200, p=0.012), and PINP (β=0.207, p=0.006) levels, a lower presence of multivessel disease (β=-0.223, p=0.005) and lower CCS angina class (β=-0.160, p=0.017). Serum sclerostin is a prognostic parameter for predicting and intervening in the adverse outcomes of elderly SCAD patients undergoing PCI, which may be explained by its potential role in the bone-vascular axis.View Large Image Figure ViewerDownload Hi-res image Download (PPT)