OBJECTIVE
To evaluate the role of traditional risk factors and biological markers of osteo-coronary comorbidity for the prognosis in patients with coronary artery disease after coronary artery bypass surgery.
MATERIAL AND METHODS
The study included 111 men under the age of 75 years with coronary artery disease and angina pectoris CCS class I—III who underwent coronary artery bypass surgery. We have assessed the incidence of endpoints (death, myocardial infarction, recurrence/aggravation of angina attacks), risk factors and predictors of poor prognosis in patients with and without cardiovascular events within 3 years after surgery.
RESULTS
After 3 years, 21 (22.1%) patients developed adverse outcomes. Patients with cardiovascular events were characterized by high smoking rate (p=0.050), high biomarkers of bone resorption (alkaline phosphatase (p=0.030), osteocalcin (p=0.010) osteopontin (p=0.040)), low levels of osteoprotegerin (p=0.020). Postoperative period was characterized by negative dynamics of proatherogenic lipid factors. The predictors of adverse outcomes within 3 years after coronary artery bypass surgery were high osteopontin level (>8.3 ng/ml, p=0.023), smoking (p=0.050), high parathyroid hormone (>49.1 pg/ml, p=0.014), osteocalcin (>26.8 ng/ml, p=0.020), alkaline phosphatase (>186 u/l, p=0.041). Moreover, high preoperative levels of osteocalcin (p=0.037) and parathyroid hormone (p=0.012) were significant factors with risk augmentation by 23.6% for one elevated factor and 75% for increase of both factors.
CONCLUSION
A three-year unfavorable prognosis of coronary artery bypass surgery is associated with increased preoperative osteocalcin, parathyroid hormone, osteopontin, alkaline phosphatase, smoking and negative lipid dynamics.