Download Osteoprotegerin levels are associated with myocardial injury and

Poster I-5
Osteoprotegerin levels are associated with
myocardial injury and function, but also heparin use
in ST-elevation myocardial infarction.
Christian Shetelig1,2,5, Shanmuganathan Limalanathan1,2,3, Jan Eritsland1,2,4, Pavel Hoffmann1, Ingebjørg Seljeflot1,2,4,5,
Jon Michael Gran5,6, Pål Aukrust5,7,8,9, Thor Ueland5,7,9, Geir Ø. Andersen1,2,4.
1Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway, 2Center for Clinical Heart Research, Oslo University Hospital
Ullevål, Oslo, Norway, 3Feiring Heart Clinic, Feiring, Norway, 4Center for Heart Failure Research, Oslo, Norway, 5Faculty of Medicine, University
of Oslo, Oslo, Norway, 6Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway, 7Research Institute of Internal
Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway, 8Section of Clinical Immunology and Infectious Diseases, Oslo University
Hospital Rikshospitalet, Oslo, Norway, 9K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway.
Poster I-5
Background and purpose
• Recent studies have shown that OPG levels are
associated with infarct size in STEMI patients,
however, the results have been inconsistent.
• Aims of the study – To evaluate:
1. The temporal profile of OPG during ST-elevation
myocardial infarction (STEMI).
2. Possible associations between OPG and infarct size,
adverse left ventricular (LV) remodeling,
microvascular obstruction (MVO) and myocardial
salvage.
3. The possible effect of heparin administration on
OPG levels.
Poster I-5
Methods
• Population: 272 patients with first-time STEMI
treated with primary percutaneous coronary
intervention (PCI).
• Blood sampling immediately before and at the end of
the PCI procedure, Day 1 (median 14.7 hours after
PCI), and at 4-month follow-up.
• Cardiac magnetic resonance imaging (CMR)
performed in the acute phase and after 4 months.
Poster I-5
Results
Figure 1. Temporal profile of OPG during the course
of STEMI. Data are presented as median (boxes)
with 25th and 75th percentile (whiskers).
Figure 2. Osteoprotegerin (OPG) levels in patients with
suspected stable coronary artery disease before and after
heparin administration. Blood samples were drawn from
patients (n=20) during elective coronary angiography. A
venous sample was taken before angiography (A). Arterial
samples were taken immediately after cannulation (B, 1 min
before heparin), and at the end of the angiography
procedure (C, 20 min after heparin).
Poster I-5
Results
Table 1. Baseline characteristics of the study population
related to osteoprotegerin (OPG) levels measured at day 1
(above or below median value).
Table 2. Myocardial injury and function measured by CMR
according to osteoprotegerin (OPG) values measured at day 1.
Data are presented as median (25th, 75th percentiles) or numbers (%). OPG
was measured median 14.7 hours after PCI.
•
Data are presented as median (25th, 75th percentile) or numbers (%).
OPG was measured median 14.7 hours after PCI.
Multivariable analyses: OPG remained
significantly associated with infarct size and
LVEF after adjustment for relevant clinical
covariates, but not after adjustment for
peak troponin T and peak CRP.
Poster I-5
Conclusions
• High levels of OPG are associated with
myocardial injury, but not adverse remodeling
or myocardial salvage.
• The role of OPG as a potential biomarker in
STEMI patients seems to be limited by a
strong association with age, confounding
effect of heparin administration, and little
additive value to well-established biomarkers
such as Troponin T and CRP.