New Marker (Osteoprotegerin) for Silent Myocardial Ischemia Risk in Diabetics Found

Researchers find a new independent marker of silent myocardial ischemia in asymptomatic diabetic patients, osteoprotegerin. Lead investigator Dr. Antoine Avignon states that,  "Additional markers, are truly necessary for optimal management of cardiovascular risk in diabetic patients."

To investigate the utility of osteoprotegerin, a substance involved in atherosclerosis, and other possible markers of cardiovascular risk, Dr. Avignon of Lapeyronie Hospital, Montpellier and colleagues studied 465 diabetic patients and identified 92 with silent myocardial ischemia.

Levels of other proteins including C-reactive protein and fibrinogen had no significant value as markers, but patients with osteoprotegerin levels above the 75th percentile were at significantly increased relative risk (3.19) of silent myocardial ischemia compared to those with lower levels.

This remained true after adjusting for other known silent myocardial ischemia risk factors including age, body mass index and blood pressure. The association remained significant in patients of both sexes with type 1 or type 2 diabetes, with or without nephropathy. However, it was not significant in patients with peripheral artery disease.

Thus, concluded Dr. Avignon, "osteoprotegerin appears as a promising marker that may help identify patients for whom non-invasive and invasive investigations are justified."

Diabetes Care Nov.2007;30:2934-2939.

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