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Osteopontin: a novel predictor of survival in patients with systemic light-chain amyloidosis

Background: 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 t...

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Main Authors: Kristen, Arnt (Author) , Rosenberg, Mark (Author) , Lindenmaier, David (Author) , Merkle, Corina (Author) , Steen, Henning (Author) , André, Florian (Author) , Schönland, Stefan (Author) , Schnabel, Philipp Albert (Author) , Schuster, Tibor (Author) , Röcken, Christoph (Author) , Giannitsis, Evangelos (Author) , Katus, Hugo (Author) , Frey, Norbert (Author)
Format: Article (Journal)
Language:English
Published: 9 July 2014
In: Amyloid
Year: 2014, Volume: 21, Issue: 3, Pages: 202-210
ISSN:1744-2818
DOI:10.3109/13506129.2014.940457
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3109/13506129.2014.940457
Verlag, lizenzpflichtig, Volltext: https://www.tandfonline.com/doi/full/10.3109/13506129.2014.940457
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Author Notes:Arnt V. Kristen, Mark Rosenberg, David Lindenmaier, Corina Merkle, Henning Steen, Florian Andre, Stefan O. Schönland, Philipp A. Schnabel, Tibor Schuster, Christoph Röcken, Evangelos Giannitsis, Hugo A. Katus, and Norbert Frey
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Summary:Background: 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.Methods: 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.Results: 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.Conclusions: 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.
Item Description:Gesehen am 23.07.2020
Physical Description:Online Resource
ISSN:1744-2818
DOI:10.3109/13506129.2014.940457

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