NPPB and heart failure: In our study, no other bone marker correlated with OS; in contrast to MM where several markers of bone remodeling are associated with OS, that is, CTX,20 NTX,16 sRANKL/OPG ratio18 or macrophage inflammatory protein one alpha.21 Cardiac involvement is considered as the most adverse prognostic factor in patients with AL,23 and the cardiac biomarkers NT-proBNP and troponins are the most important prognostic factors for OS.22 During the past decade, OPG has been implicated in the pathogenesis of heart failure of different etiologies.