Serum sclerostin and adverse outcomes in elderly patients with stable coronary artery disease undergoing percutaneous co
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ORIGINAL ARTICLE
Serum sclerostin and adverse outcomes in elderly patients with stable coronary artery disease undergoing percutaneous coronary intervention Wuyang He1 · Chunqiu Li1 · Qingwei Chen1 · Tingting Xiang1 · Peng Wang1 · Jun Pang1 Received: 29 July 2019 / Accepted: 17 October 2019 © The Author(s) 2019
Abstract Background Recently, sclerostin, a bone-derived protein, has been shown to play a key role in atherosclerosis progression. However, few studies have investigated the influence of sclerostin on cardiovascular disease prognosis. We investigated the relationship between serum sclerostin levels and adverse outcomes in elderly patients with stable coronary artery disease (SCAD) who were undergoing percutaneous coronary intervention (PCI). Methods We enrolled 310 elderly SCAD patients who underwent PCI in this study and followed them 3 years. According to the median serum sclerostin levels, subjects were stratified into a low sclerostin (low scl) group (n = 144) and a high sclerostin (high scl) group (n = 166). Time-to-event analyses were performed with the Kaplan–Meier method. Associations between sclerostin levels and main adverse cardiovascular and cerebrovascular events (MACCEs) and mortality were evaluated by Cox multivariate regression analysis. The prognostic power of predictive models was verified by the concordance index and receiver operating characteristic curve analysis. Results The high scl group had a significantly higher MACCE-free rate and better survival than the low scl group. Serum sclerostin was an independent predictor and could improve the prognostic power for adverse outcomes. In addition, serum sclerostin levels were significantly associated with bone turnover markers, a lower presence of multivessel disease and a lower CCS angina class. Conclusions Serum sclerostin is a prognostic parameter for predicting and intervening in the adverse outcomes of elderly SCAD patients undergoing PCI, which may be explained by its potential role in the bone–vascular axis. Keywords Sclerostin · Stable coronary artery disease · Percutaneous coronary intervention · Elderly
Introduction Coronary heart disease (CHD) has become the leading cause of death worldwide, increasing both mortality and the risk of disability in the elderly population. Several studies have
Wuyang He, Chunqiu Li made equal contributions to the work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40520-019-01393-2) contains supplementary material, which is available to authorized users. * Qingwei Chen [email protected]; [email protected] 1
Department of Geriatric Cardiology, The Second Affiliated Hospital of Chongqing Medical University, No 76 Linjiang Road, Chongqing 400010, China
reported that bone loss may increase the risk of CHD [1, 2], and its underlying mechanism could be explained by the “bone–vascular calcification paradox”. This phenomenon has been defined as the coincidence of bone loss and vascular calcification [3], revealing the common pathophysiologica
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