Osteopontin predicts clinical outcome in patients after treatment of severe aortic stenosis with transcatheter aortic valve implantation (TAVI).

Abstract

OBJECTIVE:

Osteopontin (OPN) is an extracellular matrix protein that plays an integral role in myocardial remodelling and has previously been shown to be a valuable biomarker in cardiovascular disease. Because of the concentric myocardial hypertrophy associated with severe, symptomatic aortic stenosis (AS), we hypothesised that OPN expression may have a prognostic value in patients undergoing transcatheter aortic valve implantation (TAVI).

METHODS:

We prospectively included 217 patients undergoing TAVI between February 2011 and December 2013 with a median follow-up of 349 days. Twenty healthy individuals from the same age range free from structural heart disease served as controls. The primary endpoint for the analysis was survival time.

RESULTS:

Median preprocedural OPN levels (675 ng/mL; IQR 488.5-990.5 ng/mL) were significantly higher in patients with severe aortic valve stenosis compared with healthy controls (386 ng/mL; IQR 324.5-458, p<0.001). Patients with increased OPN values showed at baseline a decreased 6 min walk test performance, increased rates of atrial arrhythmia, and an increased risk of death during follow-up (HR 2.2; 95% CI 1.3 to 3.5 for the comparison of the highest vs lowest OPN quartile). Multiple Cox regression analysis demonstrated that OPN improves the prediction of an adverse prognosis further than N-terminal probrain natriuretic peptide.

CONCLUSIONS:

OPN levels at baseline are associated with adverse outcomes in patients with severe, symptomatic AS undergoing TAVI.

• Authors: Matthias Lutz, Nora von Ingersleben, Moritz Lambers, Mark Rosenberg, Sandra Freitag-Wolf, Astrid Dempfle, Georg Lutter, Johanne Frank, Peter Bramlage, Norbert Frey, Derk Frank
• Journal: Open heart (Open Heart) 2017 Vol. 4 Issue 2 Pg. e000633 ISSN: 2053-3624 [Print] England
• PMID: 28761684 (Publication Type: Journal Article)