Prognostic role of osteopontin in assessing the risk of adverse cardiovascular and osteoporetic events

The purpose of the study. To evaluate the prognostic significance of osteopontin (OPN) in determining the risk of adverse cardiovascular and osteoporotic events in women with chronic heart failure (CHF) comorbid with type 2 diabetes mellitus (DM2) and osteoporosis during 36 months of observation. Material and methods. The study involved 90 women aged 50-65 years with CHF, type 2 diabetes mellitus and osteoporosis, divided into two groups depending on the initial concentration of OPN in the blood: group 1 – with OPN level ≤23,5 ng/ml and group 2 – with OPN level > 23,5 ng/ml. The combined endpoint was death from common causes, an increase in the functional class (FC) of CHF, the development of non-fatal myocardial infarction (MI), pulmonary embolism, stroke, cases of hospitalization with decompensated CHF and osteoporotic bone fractures. Results. In women with a higher level of OPN (> 23,5 ng/ml), the risk of developing cumulative complications was significantly higher (OR = 4,98, p = 0,001). Analysis of individual events revealed a significant increase in the risk of progression of FC (OR = 4,13, p = 0,001) and decompensation of CHF (OR = 2,67, p = 0,021), development of MI (OR = 5,38, p= 0,019) and osteoporotic fractures (OR = 4,86, p = 0,003) with an initial concentration of OPN > 23,5 ng/ml during 36 months of observation. The level of OPN above 23,5 ng/ml with sensitivity = 82 % and specificity = 69 % (area under the curve = 0,86, p = 0,001) predicts the occurrence of adverse cardiovascular events for the combined endpoint, and with sensitivity = 75 % and specificity = 65 % (area under the curve = 0,74, p = 0,001) – the development of osteoporotic fractures during three years of observation. Conclusion. Osteopontin is a risk factor for the development of adverse cardiovascular events and bone fractures in women with CHF, type 2 diabetes and osteoporosis.