Association of fetuin-A levels with the progression of aortic valve calcification in non-dialyzed patients.
OBJECTIVE
Fetuin-A has been identified as a potent circulating inhibitor of ectopic calcification. We investigated the relationship between baseline fetuin-A serum levels and the rate of progression of aortic valve calcification (AVC) in non-dialyzed patients with aortic valve disease (AVD).


RESULTS
Seventy-seven patients (mean age 70 +/- 8 years) with echocardiographically proven AVD were collected. In all patients, serum fetuin-A levels, creatinine, calcium, lipid parameters, and C-reactive protein were measured at baseline. For quantification of AVC progression, all patients underwent multislice spiral computed tomography examinations at baseline and after a mean follow-up of 12.6 +/- 1.4 months (range 7-18 months). In a multifactorial analysis of covariance including fetuin-A levels, baseline AVC score, the covariables sex, age, body mass index, C-reactive protein, glomerular filtration rate, serum lipids, diabetes, smoking status, and hypertension, only serum fetuin-A levels significantly predict the progression of AVC (P < 0.001). Post hoc analysis demonstrated that patients with baseline fetuin-A levels lower than the median of the cohort (0.72 g/L) showed a significantly higher increase of AVC scores (34.6 +/- 31.4%) than patients with fetuin-A levels larger than the median (10.0 +/- 11.2%, P < 0.001) despite comparable baseline AVC scores. In addition, fetuin-A levels were associated with major adverse clinical events (MACE; P = 0.03).


CONCLUSIONS
Serum levels of the calcification inhibitor fetuin-A are associated with the progression of AVC and MACE, independent of the renal function and inflammation.
Department for Cardiology, Pulmonology, and Vascular Medicine, University Hospital RTWH Aachen, RWTH University Aachen, Pauwelsstrasse 30, Aachen 52057, Germany. rkoos@ukaachen.de
Ralf
R
Koos
Vincent
V
Brandenburg
Andreas Horst
AH
Mahnken
Georg
G
Mühlenbruch
Sven
S
Stanzel
Rolf W
RW
Günther
Jürgen
J
Floege
Willy
W
Jahnen-Dechent
Malte
M
Kelm
Harald Peter
HP
Kühl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000175:diagnosis*; D001021:Aortic Valve; D001798:Blood Proteins / Q000172:deficiency / Q000378:metabolism*; D002114:Calcinosis / Q000175:diagnosis*; D017023:Coronary Angiography; D018450:Disease Progression; D004452:Echocardiography; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D036542:Tomography, Spiral Computed; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein