title: Association of serum fetuin-A levels with heart valve calcification and other biomarkers of inflammation among persons with acute coronary syndrome.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Coronary Intensive Care Unit, Ministry of Health Istanbul Education and Research Hospital, Istanbul, Turkey.
authors.forename: Cigdem U
authors.initials: CU
authors.lastname: Afsar
authors.forename: Hafize
authors.initials: H
authors.lastname: Uzun
authors.forename: Selen
authors.initials: S
authors.lastname: Yurdakul
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Muderrisoglu
authors.forename: Mecdi
authors.initials: M
authors.lastname: Ergüney
authors.forename: Bulent
authors.initials: B
authors.lastname: Demir
authors.forename: Aram
authors.initials: A
authors.lastname: Aslan
authors.forename: Hale
authors.initials: H
authors.lastname: Aral
authors.forename: Sibel
authors.initials: S
authors.lastname: Ozyazgan
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000097:blood* / Q000150:complications; D009202:Cardiomyopathies / Q000097:blood* / Q000150:complications; D005260:Female; D006349:Heart Valve Diseases / Q000097:blood* / Q000150:complications; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: C556354:AHSG protein, human; D015415:Biomarkers; D018836:Inflammation Mediators; D060749:alpha-2-HS-Glycoprotein