Relationship Between Sclerostin Levels and Coronary Artery Calcification and Plaque Compositon

OBJECTIVE
The primary function of sclerostin is regulation of bone metabolism. Research investigating the cardiovascular effects of sclerostin had conflicting results. We aimed to study serum sclerostin levels in coronary artery plaque types.


METHODS
Coronary calcium scores (CCS) of one hundred seventy-five patients were evaluated. Patients with CCS of 0 and greater than 0 constituted control (n=92) and study groups (n=83), respectively. Patients’ plaques were further categorized as non-calcified plaque (NCP), calcified plaque or mixed plaque (n=45, n=40, n=43, respectively).


RESULTS
Study group had increased serum sclerostin levels than that of controls. Moreover, sclerostin levels significantly higher in patients with calcified or mixed plaques compared to those without plaque or NCP (median 248.5, 60.7-790.4) pg/mL and 1085.8 (185.8-3902.2) pg/mL vs. 68.7 (34.0- 141.3) pg/mL, and 67.7 (48.6-94.9) pg/mL, p<0.001, respectively). Sclerostin showed high correlation with CCS (r=0.95, p<0.001). Serum sclerostin concentration of 106.27 pg/ml had 97.5% sensitivity and 67.4% specificity for prediction of calcific plaque, whereas level of 308.55 pg/ml had 95.3% sensitivity 90.9% specificity for the prediction of mixed plaque. CCS, serum sclerostin and C-reactive protein levels were the significant predictors of one-year major adverse cardiac events (MACE).


CONCLUSIONS
Increased serum sclerostin level is a marker of coronary atherosclerosis burden and has a value for prediction of one-year MACE.