BACKGROUND & AIMS: :Stable angina (SA) pectoris is a common and disabling disorder in patients with coronary artery disease (CAD), with increasing epidemiology and is associated with myocardial infarction and increased mortality. However, within the population of SA patients, an individual's prognosis can vary considerably. Except from conventional risk factors a variety of biomarkers have been evaluated for their prognostic significance in the settings of SA. Novel biomarkers associated with inflammatory status, such as C reactive protein and tumor necrosis factor alpha, with myocardial performance, such as B-type natriuretic peptide, with extracellular matrix remodeling, with vascular calcification such as osteoprotogerin and osteopontin, with myocardial ischemia, such as ischemia modified albumin have been associated with the progression of CAD and with the prognosis of SA patients. Despite the multiplicity of novel biomarkers there is lack of a clinical useful, highly specific for CAD biomarker with the ability to guide treatment decisions. In the context of this evidence in this review article we summarize the so far acquired knowledge of the most promising biomarkers and we discuss the major clinical correlations of novel risk factors with SA physical history, their predictive value for future cardiovascular events and their use in the treatment monitoring of this population.

背景与目标： : 稳定型心绞痛 (SA) 是冠状动脉疾病 (CAD) 患者中常见的致残性疾病，流行病学不断增加，并与心肌梗塞和死亡率增加有关。但是，在SA患者人群中，个体的预后可能会有很大差异。除常规危险因素外，已评估了多种生物标志物在SA设置中的预后意义。与炎症状态相关的新型生物标志物，如C反应蛋白和肿瘤坏死因子 α，与心肌性能相关，如b型利钠肽，与细胞外基质重塑，与血管钙化如骨原蛋白和骨桥蛋白，与心肌缺血，如缺血修饰的白蛋白与CAD的进展以及SA患者的预后有关。尽管新的生物标志物多种多样，但仍缺乏临床上有用的，对CAD生物标志物具有高度特异性的指导治疗决策的能力。在这篇综述文章中的这一证据的背景下，我们总结了迄今为止获得的最有前途的生物标志物的知识，并讨论了新危险因素与SA病史的主要临床相关性，它们对未来心血管事件的预测价值以及它们在该人群治疗监测中的应用。

BACKGROUND & AIMS: PURPOSE:The osteoprotogerin/receptor activator of NF-kappa β/receptor activator of NF-kappa β ligand (OPG/RANK/RANKL) pathway plays a critical role in bone remodeling. This study investigated associations between serum levels of OPG, soluble RANKL (sRANKL), and the ratio of OPG/sRANKL to risk of incident hip fracture. METHODS:A nested case-control study was conducted among postmenopausal, Caucasian women aged 50-79 at baseline (1993-1998), followed for hip fracture through March 2005 in the Women's Health Initiative Observational Study. 400 incident hip fracture cases were selected and individually matched to 400 controls with no prior fracture or incident hip fracture. Matching factors were baseline age, enrollment date and hormone therapy (HT) exposure. Baseline serum OPG and sRANKL levels were measured using high sensitivity ELISA. Odds ratios were computed for quartiles of each biomarker adjusting for matching factors and hip fracture risk factors. RESULTS:Serum OPG was significantly associated with older age, low physical activity and poorer physical function in control women. sRANKL was inversely associated with total calcium intake in control women, but not associated with age or other fracture risk factors. The odds ratio for hip fracture comparing the highest to lowest quartiles of OPG was 2.28 (95% confidence interval (CI), 1.45-3.61) after adjusting for the matching variables (p-value for linear trend <0.001), and 1.87 (95% CI, 1.15-3.04; p for linear trend=0.02) after adjusting for self-rated health status, physical activity and physical functioning. No significant associations between sRANKL or the ratio of OPG/sRANKL and hip fracture risk were observed. CONCLUSION:Serum OPG levels were independently associated with a nearly twofold increased risk of hip fracture in postmenopausal women.

背景与目标：