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Acute heart failure: prognostic value of osteoprotegerin


Osteoprotegerin ( OPG ) is promising as a predictor of adverse prognosis in patients with acute coronary syndromes and chronic heart failure. Its prognostic value in acute heart failure ( AHF ) is unknown.
The aim of a study was to assess the prognostic value provided by serum osteoprotegerin levels at discharge after an admission for acute heart failure.

In a prospective study, researchers enrolled 338 patients consecutively admitted with acute heart failure to the internal medicine department of a tertiary care university hospital in Porto, Portugal between March 2009 and December 2010.

Osteoprotegerin was measured using a commercial enzyme-linked immunosorbent assay and was both analyzed as a continuous variable and categorized by quartiles.

Patients were followed for up to 6 months after discharge to ascertain the occurrence of all-cause death or hospital readmission resulting from acute heart failure.

During follow-up, 119 patients died or were readmitted for acute heart failure.
A graded increase in the risk of the combined end point was observed across quartiles of osteoprotegerin.

At 6 months, the cumulative risk of the end point was 25% for the first quartile and 50% for the fourth quartile. The multivariable adjusted risk of death or hospitalization for acute heart failure increased progressively across categories of osteoprotegerin up to a statistically significant 2.44-fold increase in risk in the highest category ( P for linear trend = 0.002, ie, by 5% per 10 pg/mL increase in osteoprotegerin ).

In conclusion, serum osteoprotegerin was directly associated with a higher probability of death or readmission for acute heart failure within 6 months, irrespective of other known prognostic markers.
This was true both when the ejection fraction was preserved and when it was reduced. ( Xagena )

Friões F et al, Can J Cardiol 2015; Epub ahead of print

XagenaMedicine_2015



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