Okyay Kaan, Tavil Yusuf, Sahinarslan Asife, Tacoy Gulten, Turfan Murat, Sen Nihat, Gurbahar Ozlem, Boyaci Bulent, Yalcin Ridvan, Demirkan Deniz, Cengel Atiye
Department of Cardiology, Gazi University Medical School, Ankara, Turkey.
Acta Cardiol. 2011 Apr;66(2):197-202. doi: 10.1080/ac.66.2.2071251.
We sought to explain the clinical importance of the osteopontin (OPN) in the setting of acute ST-elevation myocardial infarction (STEMI).
Eighty consecutive patients (55 = 11 years, 12 women and 68 men) and sixty healthy control subjects were included in the study. In all patients, plasma OPN levels were assessed on admission and on the third day (peak value). Creatinine kinase (CK)/CK-myocardial band (MB), troponin I and N-terminal pro-brain natriuretic factor levels and echocardiographic findings were also recorded. Patients were classified into high and low OPN groups according to the median OPN value, and monitored for the occurrence of major adverse cardiovascular events (MACE).
Patients with STEMI had higher OPN levels (23.8 [16.7-41.3] ng/ml) on admission than the control subjects (18.0 [11.3-31.5] ng/ml, P = 0.004).The third day value of OPN was significantly higher (39.2 [27.2-56.0] ng/ml) than the OPN level on admission (23.8 [16.7-41.3] ng/ml, P < 0.001). Admission and peak OPN levels were not correlated with CK/CK-MB, white blood cell counts, troponin I and the N-terminal pro-brain natriuretic factor. The plasma OPN levels were not correlated with left ventricular wall motion score index either. In the subgroups of infarct localization and reperfusion strategy, plasma OPN levels were similar. When the patients were compared according to the median OPN values, there were no differences in the occurrence of MACE between the high and low OPN groups.
This study suggests, for the first time, that the plasma OPN level increases in the first hours of the acute STEMI; however, it could not be used as a prognostic biomarker of STEMI.
我们试图解释骨桥蛋白（OPN）在急性ST段抬高型心肌梗死（STEMI）中的临床重要性。
本研究纳入了80例连续患者（年龄55±11岁，12例女性，68例男性）和60名健康对照者。所有患者在入院时及第三天（峰值）评估血浆OPN水平。同时记录肌酸激酶（CK）/CK心肌同工酶（MB）、肌钙蛋白I和N末端脑钠肽前体水平以及超声心动图检查结果。根据OPN值的中位数将患者分为高OPN组和低OPN组，并监测主要不良心血管事件（MACE）的发生情况。
STEMI患者入院时的OPN水平（23.8 [16.7 - 41.3] ng/ml）高于对照者（18.0 [11.3 - 31.5] ng/ml，P = 0.004）。OPN第三天的值（39.2 [27.2 - 56.0] ng/ml）显著高于入院时的OPN水平（23.8 [16.7 - 41.3] ng/ml，P < 0.001）。入院时和峰值OPN水平与CK/CK - MB、白细胞计数、肌钙蛋白I和N末端脑钠肽前体均无相关性。血浆OPN水平与左心室壁运动评分指数也无相关性。在梗死部位和再灌注策略的亚组中，血浆OPN水平相似。根据OPN值中位数比较患者时，高OPN组和低OPN组之间MACE的发生率无差异。
本研究首次表明，急性STEMI发病后的最初数小时内血浆OPN水平升高；然而，它不能用作STEMI的预后生物标志物。
