In line with this notion, OPN serum levels correlated both with markers of liver failure (alkaline phosphatase (AP); gamma glutamyl transpeptidase (GGT), bilirubin) heart failure (BNP), clinical scores like APACHE II and SAPS2 as well as novel prognostic markers like APRIL [23] and circulating miR-133a [25]. This evidence concerns the gene NPPB and heart failure.