ORIGINAL PAPER
The interrelationship of bone and cardiovascular remodeling biomarkers and clinical peculiarities of coronary artery disease in postmenopausal women
1
Department of General Practice – Family Medicine and Internal Diseases, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
2
Department of Clinical Laboratory Diagnostics, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine
3
Department of Oncology, Radiodiagnosis, Radiotherapy and Radiation Medicine, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Submission date: 2020-04-30
Final revision date: 2020-05-26
Acceptance date: 2020-06-04
Online publication date: 2020-06-29
Publication date: 2020-06-29
Reumatologia 2020;58(3):142-149
KEYWORDS
TOPICS
ABSTRACT
Introduction:
To investigate the interrelationship between bone and cardiovascular remodeling biomarkers and some clinical, laboratory and instrumental parameters of coronary artery disease in postmenopausal women.
Material and methods:
The double open cross-sectional monocentric clinical study in parallel groups involved 115 women in the postmenopausal period with coronary artery disease (CAD): stable exertional angina of functional class (FC) II–III (mean age 67.07 ±0.92 years). Depending on the bone mineral density (BMD) state, all patients were divided into 3 groups: group 1 (n = 24) – patients with normal BMD (T-criterion more than 1 SD); group 2 (n = 34) – patients with osteopenia (T-criterion from –1 SD to –2.5 SD); group 3 (n = 44) – patients with osteoporosis (T-criterion less than –2.5 SD). The selected control group consisted of 12 relatively healthy women of the corresponding age. All patients underwent cardiovascular and bone remodeling biomarkers’ assessment, lipid profile tests, daily monitoring of ECG by Holter, two-dimensional echocardiography and pulsed-wave Doppler. Intima-media complex (IMC) measurement, ultrasound densitometry, and the FRAX algorithm were performed.
Results:
In women with coronary artery disease and postmenopausal osteoporosis (PMO), there was a significant increase in the level of bone osteoprotegerin (OPG), osteocalcin and vascular remodeling biomarkers (VEGF-A, homocysteine) in parallel with the progression of BMD disorders. The existence of a correlative dependence between osteoprotegerin level and the 10-year risk of fracture of the radial bone (r = 0.46; p < 0.05) was discovered. A probable interrelationship between the OPG, osteocalcin, VEGF-A and homocysteine level and decrease of the T-criterion was observed. An interrelationship between the bone and cardiovascular remodeling biomarkers and atherogenic dyslipidemia, diastolic dysfunction of the left ventricle, dilatation of the left atrium, thickening of the intima-media complex, arrhythmic complications and vegetative imbalance development was proved (p < 0.05), which confirms their clinical and pathogenic role in patients with CAD and PMO.
Conclusions:
The results obtained prove the existing interrelationship of bone and cardiovascular remodeling biomarkers with the state of bone mineral density and clinical peculiarities of coronary artery disease in postmenopausal women.
To investigate the interrelationship between bone and cardiovascular remodeling biomarkers and some clinical, laboratory and instrumental parameters of coronary artery disease in postmenopausal women.
Material and methods:
The double open cross-sectional monocentric clinical study in parallel groups involved 115 women in the postmenopausal period with coronary artery disease (CAD): stable exertional angina of functional class (FC) II–III (mean age 67.07 ±0.92 years). Depending on the bone mineral density (BMD) state, all patients were divided into 3 groups: group 1 (n = 24) – patients with normal BMD (T-criterion more than 1 SD); group 2 (n = 34) – patients with osteopenia (T-criterion from –1 SD to –2.5 SD); group 3 (n = 44) – patients with osteoporosis (T-criterion less than –2.5 SD). The selected control group consisted of 12 relatively healthy women of the corresponding age. All patients underwent cardiovascular and bone remodeling biomarkers’ assessment, lipid profile tests, daily monitoring of ECG by Holter, two-dimensional echocardiography and pulsed-wave Doppler. Intima-media complex (IMC) measurement, ultrasound densitometry, and the FRAX algorithm were performed.
Results:
In women with coronary artery disease and postmenopausal osteoporosis (PMO), there was a significant increase in the level of bone osteoprotegerin (OPG), osteocalcin and vascular remodeling biomarkers (VEGF-A, homocysteine) in parallel with the progression of BMD disorders. The existence of a correlative dependence between osteoprotegerin level and the 10-year risk of fracture of the radial bone (r = 0.46; p < 0.05) was discovered. A probable interrelationship between the OPG, osteocalcin, VEGF-A and homocysteine level and decrease of the T-criterion was observed. An interrelationship between the bone and cardiovascular remodeling biomarkers and atherogenic dyslipidemia, diastolic dysfunction of the left ventricle, dilatation of the left atrium, thickening of the intima-media complex, arrhythmic complications and vegetative imbalance development was proved (p < 0.05), which confirms their clinical and pathogenic role in patients with CAD and PMO.
Conclusions:
The results obtained prove the existing interrelationship of bone and cardiovascular remodeling biomarkers with the state of bone mineral density and clinical peculiarities of coronary artery disease in postmenopausal women.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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