Osteoprotegerin Is Associated With Major Bleeding But Not With Cardiovascular Outcomes in Patients With Acute Coronary Syndromes: Insights From the PLATO (Platelet Inhibition and Patient Outcomes) Trial.
Abstract | BACKGROUND: METHODS AND RESULTS: The associations between osteoprotegerin and the composite end point of cardiovascular death, nonprocedural spontaneous myocardial infarction or stroke, and non- coronary artery bypass grafting major bleeding during 1 year of follow-up were assessed by Cox proportional hazards models. Event rates of the composite end point per increasing quartile groups at baseline were 5.2%, 7.5%, 9.2%, and 11.9%. A 50% increase in osteoprotegerin level was associated with a hazard ratio (HR) of 1.31 (95% confidence interval [CI], 1.21-1.42) for the composite end point but was not significant in adjusted analysis (ie, clinical characteristics and levels of C-reactive protein, troponin T, NT-proBNP [N-terminal pro- B-type natriuretic peptide], and growth differentiation factor-15). The corresponding rates of non- coronary artery bypass grafting major bleeding were 2.4%, 2.2%, 3.8%, and 7.2%, with an unadjusted HR of 1.52 (95% CI, 1.36-1.69), and a fully adjusted HR of 1.26 (95% CI, 1.09-1.46). The multivariable association between the osteoprotegerin concentrations and the primary end point after 1 month resulted in an HR of 1.09 (95% CI, 0.89-1.33); for major bleeding after 1 month, the HR was 1.33 (95% CI, 0.91-1.96). CONCLUSIONS: CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
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Authors | Thor Ueland, Axel Åkerblom, Tatevik Ghukasyan, Annika E Michelsen, Pål Aukrust, Richard C Becker, Maria Bertilsson, Anders Himmelmann, Stefan K James, Agneta Siegbahn, Robert F Storey, Frederic Kontny, Lars Wallentin, PLATO (Platelet Inhibition and Patient Outcomes) Trial Investigators |
Journal | Journal of the American Heart Association
(J Am Heart Assoc)
Vol. 7
Issue 2
(01 12 2018)
ISSN: 2047-9980 [Electronic] England |
PMID | 29330256
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. |
Chemical References |
- Biomarkers
- Osteoprotegerin
- Platelet Aggregation Inhibitors
- TNFRSF11B protein, human
- Clopidogrel
- Ticagrelor
- Aspirin
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Topics |
- Acute Coronary Syndrome
(blood, diagnosis, drug therapy, mortality)
- Aged
- Aspirin
(administration & dosage, adverse effects)
- Biomarkers
(blood)
- Clopidogrel
(administration & dosage, adverse effects)
- Drug Therapy, Combination
- Female
- Hemorrhage
(chemically induced)
- Humans
- Male
- Middle Aged
- Osteoprotegerin
(blood)
- Platelet Aggregation Inhibitors
(administration & dosage, adverse effects)
- Risk Assessment
- Risk Factors
- Ticagrelor
(administration & dosage, adverse effects)
- Time Factors
- Treatment Outcome
- Up-Regulation
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