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

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