Prospects for a comprehensive assessment of sclerostin, arterial calcification and stiffness in the context of coronary heart disease

Background. Coronary heart disease is accompanied by increased calcification and vascular stiffness, which is associated with an increased risk of adverse cardiovascular events. This manuscript focuses on the contribution of sclerostin to the development of vascular calcification and arterial stiffness, which is a key aspect of coronary heart disease. Purpose. To assess the possibility of developing a comprehensive approach to assessing the likelihood of vascular calcification, taking into account indicators of arterial stiffness and a marker of extraosseous calcification (sclerostin) to improve noninvasive diagnostics of cardiovascular risk. Materials and methods. The study included patients with myocardial infarction and unstable angina. Arterial stiffness index and calcification were assessed taking into account coronary angiography data and 24-hour blood pressure monitoring. Serum sclerostin concentrations were measured using ELISA. Results. An increase in sclerostin concentration was found in patients with coronary artery stenosis of more than 50% in combination with intravascular calcified atherosclerotic plaques. A strong correlation was found between serum sclerostin concentration and arterial stiffness index. Results on a significant increase in the arterial stiffness index against the background of coronary artery calcification were obtained. The results of ROC analysis showed the possibility of using threshold value of arterial stiffness index in assessing the severity of coronary artery disease. Conclusion. Understanding the relationship between sclerostin, calcification and vascular stiffness can help in the development of new strategies for the diagnosis, prevention and treatment of coronary artery disease.