Serum osteopontin is associated with coronary plaque vulnerability and short-term cardiovascular events: a prospective cohort study.

Serum SPP1 levels were significantly higher in patients with vulnerable plaques compared to those with stable plaques.

• Mean SPP1 was 55.85 ± 12.26 ng/mL in the vulnerable plaque group versus 39.18 ± 9.42 ng/mL in the stable plaque group.
• The difference was statistically significant (P < 0.001).
• Plaque classification was based on IVUS/OCT intravascular imaging.
• The study included 300 patients total, with 150 classified as having vulnerable plaques.

Elevated SPP1 levels were independently associated with plaque vulnerability in multivariable logistic regression analysis.

• OR = 1.08 per unit increase in SPP1 (95% CI: 1.05–1.11; P < 0.001).
• The association remained significant after multivariable adjustment.
• This was a prospective observational cohort study design.

SPP1 demonstrated superior discriminatory performance for identifying vulnerable plaques by ROC analysis.

• AUC = 0.875 (95% CI: 0.837–0.913) for SPP1 in distinguishing vulnerable from stable plaques.
• ROC analysis was performed alongside multivariable regression and survival analyses.

Higher baseline SPP1 levels were independently associated with major adverse cardiovascular events (MACE) during 6-month follow-up.

• HR = 1.35 (95% CI: 1.11–1.64; P = 0.002) in multivariable Cox regression.
• Kaplan-Meier analysis showed significantly lower MACE-free survival in the high SPP1 group (log-rank P = 0.004).
• Participants were followed for 6 months to record MACE.

SPP1 was significantly associated with inflammatory biomarkers MMP-9, IL-6, and hsCRP in multivariable analyses.

• SPP1 was most strongly associated with MMP-9 (β = 0.71, P < 0.01).
• Association with IL-6 was also significant (β = 0.42, P < 0.01).
• Association with hsCRP was weaker (β = 0.08, P < 0.01).

MMP-9 partially mediated the association between SPP1 and coronary plaque vulnerability.

• Mediation analysis indicated MMP-9 accounted for 44.2% of the total effect of SPP1 on plaque vulnerability.
• The mediation was described as partial, indicating SPP1 also has direct associations with plaque vulnerability independent of MMP-9.