Prognostic significance of arterial stiffness and osteoprotegerin in patients with stable coronary artery disease.
BACKGROUND
Arterial stiffness and vascular calcification significantly contribute to coronary atherosclerosis progression. The prognostic value of increased arterial stiffness and vascular calcification in subjects with stable coronary artery disease (CAD) after percutaneous coronary intervention(PCI) is currently under question.


MATERIALS AND METHODS
We randomly enrolled 262 patients with stable CAD 1 month after successful PCI. Carotid-femoral pulse wave velocity (PWV) was measured as a well-established index of central aortic stiffness. Osteoprotegerin (OPG) plasma levels were measured as a biomarker of vascular calcification. Patients were followed up prospectively up to 52 months. The primary endpoint was the composite of death from cardiovascular causes, myocardial infarction, stroke or hospitalization for cardiovascular causes.


RESULTS
During the follow-up period, 48 patients presented the primary composite endpoint. Subjects who presented the primary endpoint, compared to subjects free of cardiovascular events, had significantly increased PWV (9.45 ± 2.19 m/s vs 8.73 ± 2.07 m/s, P = .04) and OPG levels (4.21 ± 2.19 pmol/L vs 3.18 ± 1.74 pmol/L, P = .003). Survival analysis indicated that PWV predicted adverse cardiac events MACE (Hazard ratio = 1.29 95%CI: 1.07-1.57, P = .008) independently from confounders such as age, sex, smoking habits, ejection fraction, extent of coronary artery disease, hypertension and diabetes mellitus. Interestingly, for every increase in pulse wave velocity by 1 m/s, there is an anticipated increase in the risk of major adverse cardiovascular event (MACE) by 29%.


CONCLUSIONS
These findings extend the current knowledge concerning the role of arterial stiffness as powerful biomarkers in cardiovascular disease. Measurement of PWV might have a role in ascertaining prognosis and managing treatment in patients with stable CAD after PCI.
['Siasos|Gerasimos|G|http://orcid.org/0000-0001-7601-8870', 'Oikonomou|Evangelos|E|', 'Maniatis|Konstantinos|K|', 'Georgiopoulos|Georgios|G|', 'Kokkou|Eleni|E|', 'Tsigkou|Vasiliki|V|', 'Zaromitidou|Marina|M|', 'Antonopoulos|Alexis|A|http://orcid.org/0000-0001-9137-0143', 'Vavuranakis|Manolis|M|', 'Stefanadis|Christodoulos|C|', 'Papavassiliou|Athanasios G|AG|', 'Tousoulis|Dimitris|D|']
D015415:Biomarkers D002318:Cardiovascular Diseases D003324:Coronary Artery Disease D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D053244:Osteoprotegerin D011379:Prognosis D012307:Risk Factors D059289:Vascular Stiffness
arterial stiffness osteoprotegerin coronary artery disease vascular calcification atherosclerosis prognosis