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.
Koos
Ralf
R
Department for Cardiology, Pulmonology, and Vascular Medicine, University Hospital RTWH Aachen, RWTH University Aachen, Pauwelsstrasse 30, Aachen 52057, Germany. rkoos@ukaachen.de
Brandenburg
Vincent
V
Mahnken
Andreas Horst
AH
Mühlenbruch
Georg
G
Stanzel
Sven
S
Günther
Rolf W
RW
Floege
Jürgen
J
Jahnen-Dechent
Willy
W
Kelm
Malte
M
Kühl
Harald Peter
HP
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