FP403ASSOCIATION BETWEEN SERUM OSTEOPROTEGERIN & SERUM HIGH SENSITIVITY CARDIAC TROPONIN T LEVELS WITH CARDIOVASCULAR CALCIFICATION IN CHRONIC KIDNEY DISEASE

Abstract

Introduction and Aims: Chronic kidney disease (CKD) has emerged as a significant independent risk factor for cardiovascular disease (CVD) which is considered the leading cause of mortality in CKD patients. Cardiovascular calcification (CVC) is an active process involving a complex interaction of inducers and inhibitors. It is more severe and extensive in CKD, and its prevalence increases steadily with the disease progression. Silent myocardial injury is responsible for the development of adverse cardiac events even in patients with early stages of CKD. High sensitivity cardiac troponin T (hs-cTnT) assay detects troponin T with higher sensitivity and precision at an earlier point of time than the conventional assays, and its elevation is associated with poor outcomes. Serum Osteoprotegerin (OPG) is classed as an inhibitory factor for CVC. It is involved in the pathological processes of vascular damage and linked to the excess car-diovascular morbidity in CKD. The aim of the present study was to evaluate the extent of cardiovascular calcifications and their associations with serum OPG and hs-cTnT levels in patients with CKD stages 3-5. Methods: Ninety CKD patients were enrolled in this study, and they were divided into 2 groups: group I included 45 non-dialysis-dependent CKD patients (stages 3-5) and group II included 45 chronic hemodialysis patients. Each group further subdivided according to the presence of CVC into subgroup A and B. Vascular calcifications were assessed by lateral lumbar, pelvis and hands X-ray radiographs. Valvular calcification was assessed by echocardiography. Serum cardiac troponin T was measured by high sensitivity assay and serum OPG was measured by ELISA. Results: Cardiovascular calcification distribution was 22.2% in group I and 33.3% in group II. Serum levels of OPG and hs-cTnT in calcification groups (IA and IIA) were significantly higher than non-calcification groups (IBandIIB) (P < 0.001). CVCcorre-lated positively with OPG, hs-cTnT and phosphorus. OPG and phosphorus were significant independent predictors of CVC at cut-off values > 4.6 ng/L and > 6.95 mg/dl, respectively (P < 0.001). Conclusions: Serum osteoprotegerin and serum hs-cTnT levels are strongly associated with CVC. In addition, there is a positive association between CVC and hs-cTnT. This suggests a role for OPG in the pathogenesis and risk stratification of CVC and myocardial injury in CKD patients is strongly linked with CVC.