Abstract
OBJECTIVES: To investigate the interrelationship between bone and cardiovascular remodeling biomarkers and some clinical, laboratory and instrumental parameters of coronary artery disease in postmenopausal women. MATERIAL AND METHODS: The double open cross-sectional monocentric clinical study in parallel groups involved 115 women in the postmenopausal period with coronary artery disease (CAD): stable exertional angina of functional class (FC) II-III (mean age 67.07 ±0.92 years). Depending on the bone mineral density (BMD) state, all patients were divided into 3 groups: group 1 (n = 24) - patients with normal BMD (T-criterion more than 1 SD); group 2 (n = 34) - patients with osteopenia (T-criterion from -1 SD to -2.5 SD); group 3 (n = 44) - patients with osteoporosis (T-criterion less than -2.5 SD). The selected control group consisted of 12 relatively healthy women of the corresponding age. All patients underwent cardiovascular and bone remodeling biomarkers' assessment, lipid profile tests, daily monitoring of ECG by Holter, two-dimensional echocardiography and pulsed-wave Doppler. Intima-media complex (IMC) measurement, ultrasound densitometry, and the FRAX algorithm were performed. RESULTS: In women with coronary artery disease and postmenopausal osteoporosis (PMO), there was a significant increase in the level of bone osteoprotegerin (OPG), osteocalcin and vascular remodeling biomarkers (VEGF-A, homocysteine) in parallel with the progression of BMD disorders. The existence of a correlative dependence between osteoprotegerin level and the 10-year risk of fracture of the radial bone (r = 0.46; p < 0.05) was discovered. A probable interrelationship between the OPG, osteocalcin, VEGF-A and homocysteine level and decrease of the T-criterion was observed. An interrelationship between the bone and cardiovascular remodeling biomarkers and atherogenic dyslipidemia, diastolic dysfunction of the left ventricle, dilatation of the left atrium, thickening of the intima-media complex, arrhythmic complications and vegetative imbalance development was proved (p < 0.05), which confirms their clinical and pathogenic role in patients with CAD and PMO. CONCLUSIONS: The results obtained prove the existing interrelationship of bone and cardiovascular remodeling biomarkers with the state of bone mineral density and clinical peculiarities of coronary artery disease in postmenopausal women.