Association of serum fetuin-A levels with heart valve calcification and other biomarkers of inflammation among persons with acute coronary syndrome

Cigdem U. Afsar, Hafize Uzun, Selen Yurdakul, Cuneyt Muderrisoglu, Mecdi Ergüney, Bulent Demir, Aram Aslan, Hale Aral, Sibel Ozyazgan


Purpose: Fetuin-A is a multifunctional hepatic secretory protein that inhibits dystrophic vascular and valvular calcification. Our aim was to evaluate the relationship among fetuin-A levels, heart valve calcification and other biomarkers of inflammation in patients with acute coronary syndrome (ACS).

Methods: The associations among serum fetuin-A concentrations, mitral annular (MAC) and aortic valve calcification and other biomarkers of inflammation (hs-CRP, ferritin, fibrinogen, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), albumin levels) were evaluated in ACS patients and healthy controls. The study included 95 patients (mean age 61.8±12.10 years) and 81 healthy controls (mean age 48.33±9.19 years).

Results: Fetuin-A levels were significantly lower in patients with ACS than in healthy controls (0.76 ± 0.23 and 1.10 ± 0.45 g/L, respectively; p < 0.001). Fetuin-A was lower in patients with mitral annular calcification (p=0.007) and aortic (p=0.001) valve calcification. In patients with ACS, there was a negative correlation among serum urea (r=-0.377; p < 0.001) and creatinine (r=-0.232; p=0.024) levels and fetuin-A, and a negative correlation among WBC (r=-0.156; p=0,132), ESR (r=-0.214; p=0.037), hs-CRP (r=-0.220; p=0.032) levels and fetuin-A. A positive correlation was seen between albumin and fetuin-A (r=0.362; p < 0.001). Multivariate logistic regression analysis revealed that fetuin-A was the variable that had a significant effect on ACS (p = 0.020 OR = .015; (95% CI)(0.000–0.520).

Conclusion: Fetuin-A levels decrease in patients with acute coronary syndromes, independent of heart valve calcification. Fetuin-A may therefore act as a negative acute phase protein after myocardial infarction.

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