Evaluation of the osteogenic regulating proteins and inflammatory profile of patients with acute myocardial infarction and asymptomatic subjects with coronary artery calcification

Abstract

The coronary artery calcification (CAC) is a marker of atherosclerosis and an important predictor of acute myocardial infarction (AMI). The osteogenic regulating proteins (ORP) play a role on CAC initiation and progression, and may be stimulated by vascular inflammation. However, remains unclear: which ORPs are closely related to CAC; how ORPs are affected by AMI; and what is the correlation between ORPs and atherosclerotic inflammatory markers. Objectives. In this study, we aim to: (1) Evaluate the acute and subacute phase patterns of the ORPs after an AMI; (2) Identify which ORPs are closely related to CAC in asymptomatic subjects; and (3) Correlate ORPs and inflammatory markers in asymptomatic subjects and in AMI patients. Methods: This is an observational study with a primary transversal outcome. One hundred and seventy patients will be enrolled and divided in: (1) AMI group, n=40; (2) asymptomatic patients with CAC (calcium score > 300), n=100; and (3) healthy subjects (calcium score = zero), n=30. All patients will be submitted to ORPs (osteoprotegerin/RANKL, osteopontin, bone morphogenic protein-2, fetuin-A, matrix glutamic protein), inflammatory markers (C-reactive protein, oxidized LDL, tumoral necrosis factor-± e tumor growth factor-beta) and metabolic profile measurement on inclusion. In the AMI group, these parameters will be repeated in 30 days to test the profile of these markers after the acute phase. The plasma levels of ORPs will be compared between: (1) Asymptomatic patients with CAC and healthy subjects; (2) AMI patients (acute and chronic phase) and healthy subjects; and (3) Acute and chronic phase of AMI patients (30 days). The levels of ORPs and inflammatory markers will be correlated in all groups, as the levels of ORPs and the calcium score in asymptomatic patients with CAC. (AU)