Osteoprotegerin and B-type natriuretic peptide in non-ST elevation acute coronary syndromes: Relation to coronary artery narrowing and plaques number

Background: To analyse osteoprotegerin (OPG), and B-type natriuretic peptide (BNP) levels in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), in relation to clinical presentation and to coronary atherosclerosis diffusion. OPG has been found in several tissues, including the cardiovascular system, BNP is selectively produced by myocardial cells. Methods: 178 consecutive patients were classified in three groups: stable angina (SA), unstable angina/non-ST elevation myocardial infarction (NSTE-ACS) and control group, measuring OPG and BNP at hospital admission. We compared both biomarkers in relation to the number of coronary narrowed vessels (1-, 2-, 3- or 4- vessels disease), and to the stenoses degree by Duke Jeopardy score. Results: OPG levels were higher in patients respect to controls (p < 0.0001). Patients with SA showed more elevated levels than controls (2.6 +/- 1.2 vs 7.4 +/- 5.0 pmol/l p<0.01). However patients with NSTE-ACS had higher OPG level with respect to SA patients (11.8 +/- 7.1 pmol/l p<0.001). A positive relation was found between OPG levels and number of coronary plaques by Duke Jeopardy score (r=0.65). BNP levels were higher in patients with NSTE-ACS respect to controls and SA patients (p<0.001). Besides, BNP was significantly higher in multivessels vs I-vessel disease (p<0.001). Conclusions: Patients with NSTE-ACS show high OPG levels. OPG increase seems related to the number of plaques in the coronary vessels, suggesting its involvement in the coronary disease progression. BNP is also increased during NSTE-ACS and more associated to coronary narrowing. (C) 2008 Published by Elsevier B.V.