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European Heart Journal Advance Access published online on January 18, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi730
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received September 20, 2005
Revised December 16, 2005
Accepted December 23, 2005

Clinical research

Prognostic significance of plasma osteopontin levels in patients with chronic stable angina

Piercarlo Minoretti 1, Colomba Falcone 2, Margherita Calcagnino 3, Enzo Emanuele 4, Maria P. Buzzi 3, Enrico Coen 4, and Diego Geroldi 4 *

1 Department of Cardiology, Alessandro Manzoni Hospital of Lecco, Lecco, Italy; Interdepartmental Center for Research in Molecular Medicine (CIRMC), University of Pavia, Viale Taramelli 24, I-27100 Pavia, Italy
2 Interdepartmental Center for Research in Molecular Medicine (CIRMC), University of Pavia, Viale Taramelli 24, I-27100 Pavia, Italy; Department of Cardiology, IRCCS San Matteo Hospital, University of Pavia, Pavia, Italy
3 Department of Cardiology, IRCCS San Matteo Hospital, University of Pavia, Pavia, Italy
4 Interdepartmental Center for Research in Molecular Medicine (CIRMC), University of Pavia, Viale Taramelli 24, I-27100 Pavia, Italy

* To whom correspondence should be addressed.
Diego Geroldi, E-mail: ccirmc{at}unipv.it


  Abstract

Aims Levels of the secreted glycophosphoprotein osteopontin (OPN) have been associated with the presence and extent of coronary artery disease (CAD). The present study assessed the relationship between plasma OPN concentrations and prognosis in patients with chronic stable angina (CSA).

Methods and results OPN was measured in baseline plasma samples from 799 patients with stable angina pectoris and angiographically documented CAD. Participants were prospectively followed-up for a median of 2.7 years (maximum 4.1 years). The primary study endpoint was the composite of non-fatal myocardial infarction and death from cardiovascular causes. In the univariate Cox proportional hazard analysis, the log-transformed OPN level [hazard ratio (HR) 1.79, 95% CI 1.35-2.36, P < 0.001] was significantly related to adverse outcome. In addition, hypertension, levels of C-reactive protein, and statin use were associated with future adverse events. Levels of OPN (HR, 1.88; P < 0.001) and C-reactive protein (HR, 1.42; P = 0.003), as well as the presence of hypertension (HR, 2.39; P = 0.008) remained statistically significant, independent predictors of adverse cardiovascular outcome in a multivariable Cox proportional hazard analysis.

Conclusion Baseline levels of OPN are an independent predictor of future adverse cardiac events in patients with CSA and may be useful for risk stratification.

Keywords: Osteopontin; Stable angina; Prognosis; Risk stratification.
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