This editorial refers to ‘Prognostic significance of plasma osteopontin levels in patients with chronic stable angina’† by P. Minoretti et al., on page 802 Minoretti et al. 1 describe the independent prognostic significance of plasma osteopontin (OPN). OPN was measured in baseline plasma samples from 799 patients with stable angina pectoris and angiographically documented coronary artery disease (CAD). Participants were prospectively followed for a median of 2.7 years. The primary study endpoint was a composite of non-fatal myocardial infarction and cardiovascular death. Age, number of diseased vessels, and treatment with statins were independent predictors of baseline plasma OPN levels. In univariate analysis, the log-transformed OPN level, levels of C-reactive protein, hypertension, and statin use were associated with future adverse events. Levels of OPN and C-reactive protein and hypertension remained independent predictors of adverse cardiovascular outcome in multivariable analysis. The study was limited to a patient population with angiographically documented stable CAD. Future studies in populations with subclinical disease (e.g. <50% angiographic stenosis or plaque by other imaging modalities) will be crucial to assess the prognostic value of OPN in primary disease prevention. OPN is a calcium-binding, phosphorylated glycoprotein, which was originally identified as a mediator involved in bone remodelling. However, subsequent studies demonstrated that OPN … *Corresponding author. Tel: +1 216 445 7579; fax: +1 216 445 6855. E-mail address : schoenp1{at}ccf.org