Coronary artery disease
Relation of Osteoprotegerin to Coronary Calcium and Aortic Plaque (from the Dallas Heart Study)

https://doi.org/10.1016/j.amjcard.2006.08.064Get rights and content

Circulating osteoprotegerin (OPG) has been shown to be elevated in patients with vascular disease. The role of OPG as a biomarker for atherosclerosis in a large, unselected population is not well known. Plasma OPG levels were measured in 3,386 subjects in the Dallas Heart Study, a multiethnic, population-based probability sample of adults aged 30 to 65 years. Coronary artery calcium (CAC) was measured by electron beam computed tomography. Aortic plaque was assessed by magnetic resonance imaging. Multivariable logistic regression was used to assess associations among OPG, cardiovascular risk factors, CAC, and aortic plaque. Age, female gender, black race, smoking, personal and family history of coronary artery disease (CAD), diabetes mellitus, hyperlipidemia, CAC, and aortic plaque were significantly associated with higher plasma OPG levels (p <0.01) in univariable analyses. The prevalence of CAC and aortic plaque increased across OPG quartiles (p <0.001 for each). An OPG level in the fourth quartile was independently associated with CAC (RR 1.39, 95% confidence interval 1.01 to 1.93) and aortic plaque (RR 1.42, 95% confidence interval 1.09 to 1.86) after adjustment for age, gender, smoking, diabetes, hyperlipidemia, and family history of premature CAD. In conclusion, plasma OPG is independently associated with CAC and aortic plaque in an unselected population, suggesting it may be a novel biomarker for atherosclerosis in humans.

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Study population

The Dallas Heart Study is a population-based, multiethnic, probability sample of 6,101 subjects in Dallas County designed to study cardiovascular disease. Details of the study design and characteristics of the enrolled cohort have been previously described.9 An initial visit for 6,101 participants included a detailed in-home interview for demographic and health-related data, as well as measurements of weight, heart rate, and 5 sequential blood pressure measures. All subjects between the ages of

Results

A total of 3,386 subjects in the Dallas Heart Study underwent measurement of plasma OPG levels. Figure 1 illustrates the distribution of OPG levels in the study population, excluding 16 subjects having plasma OPG >5,000 pg/ml. The median OPG concentration was 1,209 pg/ml. Of the 3,386 subjects in whom plasma OPG levels were measured, 2,730 underwent EBCT scanning for determination of CAC score. Detectable CAC (average CAC score >10 Agatston units on 2 successive scans) was present in 580 (21%)

Discussion

In a large multiethnic population-based sample, plasma OPG levels were associated with the prevalence and extent of CAC and with aortic plaque, specific markers of atherosclerosis. The association between OPG and both measures of atherosclerosis remained statistically significant after adjustment for conventional cardiovascular risk factors.

The results of this study extend previous evidence suggesting an association between elevated circulating OPG levels and vascular disease. In these previous

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    The Dallas Heart Study was funded by the Donald W. Reynolds Foundation, Las Vegas, Nevada.

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