The diagnostic and prognostic value of biomarkers in women with coronary artery disease and osteoporosis

Abstract

Introduction. Since the onset of menopause, the incidence of cardiovascular pathology and changes in bone mineral density (BMD) in the female population significantly increase. The objective of the study. To determine the diagnostic and prognostic value of bone and cardiovascular remodeling biomarkers in terms of determining their interrelationship with coronary artery disease (CAD) progression on the background of postmenopausal osteoporosis (PMOS). Material and methods. The study involved 115 women in the postmenopausal period, with a diagnosis of CAD. Depending on the BMD state, patients were divided into three groups: (1) – with normal BMD, (2) – with osteopenia, (3)- with osteoporosis. The selected control group consisted of 12 relatively healthy women of the corresponding age. Daily monitoring of electrocardiogram by Holter, two-dimensional echocardiography, intima-media thickness (IMT) measurement, the ultrasound densitometry, and FRAX algorithm were performed. The levels of cardiovascular and bone remodeling biomarkers were assessed. Results. In women with CAD and PMOS, there was a significant increase in the level of bone (osteoprotegerin, osteосalcin) and cardiovascular remodeling biomarkers (VEGF-A, homocysteine). By means of the ROC analysis, the cut-off values of biomarkers for osteopenia and osteoporosis were determined. The results of the relative risk (RR) assessment showed a probable interrelationship between the course of CAD and PMOS. Conclusions. The levels of biomarkers, ​determined by the ROC analysis, can be used for early diagnosis of bone structure disorders, and also for predicting the course of CAD on the background of PMOS.

Keywords

• coronary artery disease
• postmenopausal osteoporosis
• osteopenia
• serum biomarkers
• relative risk