Bone Hormone Levels Predict Heart Failure Deaths

Circulating levels of a bone hormone are predictive of death and hospitalization for heart failure after acute coronary syndrome.

The level of osteoprotegerin (OPG), a member of the tumor necrosis factor receptor superfamily, can be measured using an enzyme-linked immunosorbent assay (ELISA) utilizing monoclonal antibodies.

A study OPG levels in the plasma of 1,229 patients with chronic heart failure (CHF) from 51 clinical centers, was carried out at Akershus University Hospital (Lørenskog, Norway). OPG levels were quantified by an in-house time-resolved immunofluorometric assay modified from an ELISA using commercially available monoclonal antibodies (R&D Systems; Abingdon, UK). The limit of detection for OPG was 15 ng/L.

During a median follow-up time of 3.9 years, 332 patients died and 791 patients died or were hospitalized because of cardiovascular causes. The median value of OPG was 1,509 ng/L (interquartile range: 1,102-2,185 ng/L). Circulating OPG levels were associated with a number of conventional risk markers. Patients with higher OPG levels were more likely to be older, to be female, to have more severe heart failure as evaluated by higher functional evaluation, and to have heart failure of ischemic etiology.

The main findings of this study of patients with CHF are that circulating concentrations of OPG are strongly and independently associated with all-cause mortality as well as with the incidence of the combined end point of mortality or cardio-vascular events. However, reclassification analyses suggest that the statistically significant association is unlikely to improve risk stratification of heart failure patients in a clinically meaningful way. The results showed that patients with the highest tertile of OPG were twice as likely to die during follow-up as the patients with the lowest tertile levels of OPG were.

Torbjørn Omland, M.D. Ph.D., the lead author of study, said, "The finding is interesting not only because it suggests that there is a link between bone metabolism and heart disease, but because it might help to identify heart failure patients who are at greatest risk. As medical practitioners, we can then target those patients earlier with intensified therapy.” The study was published in August 2010 issue of the American Heart Journal.

Related Links:
Akershus University Hospital
R&D Systems