High levels of OPG hormone associated with adverse outcome after myocardial infarction

Patients suffering with heart failure are more likely to die if they have high levels of a bone hormone called osteoprotegerin (OPG).  That is the finding of a research team from the Akershus University Hospital and the University of Oslo in Norway, in collaboration with colleagues in Italy and Denmark.  Heart failure currently affects 14 million people in Europe, and is an increasing health problem.  It develops when the heart is not able to deliver sufficient amounts of oxygenated blood to the rest of the body. 

Previous research has speculated that the OPG hormone, which is thought to prevent the loss of bone tissue, might be linked to heart failure.  According to Professor Torbjørn Omland of the University of Oslo: "Studies using mice have demonstrated that reduction in OPG levels can lead to the development of osteoporosis, but also cause calcification of the major blood vessels.  And in humans, it has been observed that calcification of blood vessels is frequently accompanied by the loss of bone tissue.  Paradoxically, however, while animal studies suggest that increased levels of OPG protect the blood vessels, human studies suggest that high levels are associated with adverse outcome after myocardial infarction, a common precursor of heart failure" 

Because this link between OPG and heart failure is unclear, the study set out to properly address the prognostic implications of OPG in patients with chronic heart failure.  OPG levels were measured in blood samples from 1,229 patients with chronic heart failure.  These patients were participating in the Italian GISSI-HF trial (Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico - HF), and they were followed for an average of 3.9 years.  The results showed that patients with the highest 1/3 levels of OPG were twice as likely to die during follow-up, than the patients with the lowest 1/3 levels of OPG.

Professor Omland, a co-author of the study concluded: "The finding is interesting not only because it suggests that there is a link between bone metabolism and heart disease, but because it might help to identify heart failure patients who are at greatest risk.  As medical practitioners, we can then target those patients earlier with intensified therapy".