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Open AccessArticle

Increased Serum Parathyroid Hormone, Osteocalcin and Alkaline Phosphatase Are Associated with a Long-Term Adverse Cardiovascular Outcome after Coronary Artery Bypass Graft Surgery

1
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo 650002, Russia
2
Department of Cardiology and Cardiovascular Surgery, Kemerovo State Medical University, Kemerovo 650056, Russia
*
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(4), 143; https://doi.org/10.3390/diagnostics9040143
Received: 11 September 2019 / Revised: 3 October 2019 / Accepted: 5 October 2019 / Published: 8 October 2019
(This article belongs to the Section Pathology and Molecular Diagnostics)
Despite the fact that an association of osteopoenia/osteoporosis with elevated risk of coronary artery calcification (CAC) and coronary atherosclerosis (CA) is well-established, it remains unclear whether bone turnover markers can be employed in long-term prognostication of such patients. Here we measured serum calcium, phosphate, calcitonin, parathyroid hormone (PTH), osteoprotegerin, osteocalcin, osteopontin, alkaline phosphatase and its bone isoenzyme, subsequently correlating them with an adverse cardiovascular outcome after 3 years of follow-up. The extent of brachiocephalic artery stenosis, CA, or CAC, as well as prevalence of osteopoenia/osteoporosis before the coronary artery bypass graft (CABG) surgery, did not differ between outcome groups, suggesting that subtle molecular mechanisms might be involved in determining the outcome rather than clinical or subclinical disease. After stepwise logistic regression, serum osteocalcin > 26.8 ng/mL and PTH > 49.1 pg/mL were independent predictors of an adverse outcome. Serum ionised calcium correlated with multivessel coronary artery disease; moreover, patients with severe CA (SYNTAX score > 21) had higher serum ionised calcium than those with mild CA. Likewise, serum alkaline phosphatase was associated with severe CA and CAC (Agatston score > 400). In conclusion, serum PTH, osteocalcin, and alkaline phosphatase are associated with an adverse cardiovascular outcome 3 years after CABG surgery regardless of osteopoenia/osteoporosis, coronary/peripheral atherosclerosis, and CAC. View Full-Text
Keywords: osteopoenia; osteoporosis; coronary atherosclerosis; coronary artery disease; adverse outcome; bone turnover markers; ionised calcium; osteocalcin; parathyroid hormone; alkaline phosphatase osteopoenia; osteoporosis; coronary atherosclerosis; coronary artery disease; adverse outcome; bone turnover markers; ionised calcium; osteocalcin; parathyroid hormone; alkaline phosphatase
MDPI and ACS Style

Barbarash, O.; Zykov, M.; Kashtalap, V.; Hryachkova, O.; Kokov, A.; Gruzdeva, O.; Shibanova, I.; Kutikhin, A. Increased Serum Parathyroid Hormone, Osteocalcin and Alkaline Phosphatase Are Associated with a Long-Term Adverse Cardiovascular Outcome after Coronary Artery Bypass Graft Surgery. Diagnostics 2019, 9, 143.

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