Osteopontin: a novel predictor of survival in patients with systemic light-chain amyloidosis. (September 2014)

• Record Type: Journal Article
• Authors: Kristen, Arnt V.; Rosenberg, Mark; Lindenmaier, David; Merkle, Corina; Steen, Henning; Andre, Florian; Schönland, Stefan O.; Schnabel, Philipp A.; Schuster, Tibor; Röcken, Christoph; Giannitsis, Evangelos; Katus, Hugo A.; Frey, Norbert
• Is Part Of: Amyloid. Volume 21:Number 3(2014)
• Page Start: 202
• Page End: 210
• Publication Date: 2014-09
• Subjects: Amyloidosis -- Periodicals; 616.3995
• DOI: 10.3109/13506129.2014.940457
• Languages: English
• ISSNs: 1350-6129

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background</italic>: Troponin-T (cTnT) and NT-proBNP provide prognostic information in light-chain amyloidosis (AL). Thus, these biomarkers are widely used in clinical routine for risk stratification. Recently, plasma level of osteopontin (OPN), a secreted phosphoglycoprotein expressed by a variety of cell types, has been reported as a risk predictor in various cardiovascular diseases.</p> <p> <italic>Methods</italic>: OPN was determined retrospectively in 150 consecutive patients newly diagnosed with AL amyloidosis. All patients were evaluated according to a routine protocol including electrocardiography, echocardiography and laboratory testing.</p> <p> <italic>Results</italic>: Mean OPN was 591 ± 37 ng/mL. Cardiac involvement was established in 83 (55.3%). Median OPN plasma level were associated with number of organs involved, renal function, eligibility for high-dose melphalan chemotherapy and autologous stem cell transplantation, and severity of cardiac amyloidosis. Median follow-up was 19.2 months. 1-year all-cause-survival was 83.4%. The cut-offs discriminating 1-year all-cause-mortality for NT-proBNP, troponin T, and OPN were 2544 ng/L, 0.035 µg/L, and 426.8 ng/mL, respectively. Outcome was worse in patients with biomarkers above the individual ROC derived cut-off. A significant improvement of survival was observed in patients with cTNT >0.035 µg/L or NT-proBNP >2544 ng/L and OPN below ROC-derived cut-off of 426.8 ng/mL as compared to patients with OPN above 426.8 ng/L. No further discrimination was achieved by OPN in the cohorts of low troponin T or low NT-proBNP, respectively. Separate multivariate models identified OPN (cut-off 426.8 ng/mL) and troponin T (cut-off 0.035 µg/L) as independent predictors of all-cause-mortality.</p> <p> <italic>Conclusions</italic>: These data demonstrated that OPN appears to be a valuable marker in the clinical routine for evaluation of patients with AL amyloidosis, especially if it is used in combination with cTNT and/or NT-proBNP.</p> </abstract>