title: Fetuin-A is related to infarct size, left ventricular function and remodelling after acute STEMI.
abstract: To investigate the relationship between plasma fetuin-A, an anti-inflammatory glycoprotein which might be involved in myocardial healing after acute infarction, and infarct size, left ventricular (LV) function and dimensions as well as the occurrence of adverse remodelling at 4 months after acute ST segment elevation myocardial infarction (STEMI).
  
  
  
  In this single-centre prospective, observational study, 89 patients underwent cardiac MR within the first week and 4 months after mechanical reperfusion for first STEMI. Infarct size, LV function and dimensions were assessed at both time points. Fetuin-A levels were determined from blood samples drawn at a median of 49 h (IQR 30-59 h) after STEMI by an immunofluorescent assay.
  
  
  
  Fetuin-A levels (median 568 µg/mL, IQR 478-763 µg/mL) were significantly correlated with infarct size and LV ejection fraction at baseline and follow-up (all p<0.05). Moreover, fetuin-A was related to the increase in the end-diastolic volume index (r=-0.383, p<0.001). According to multivariate logistic regression analysis, fetuin-A concentrations (HR=0.17, 95% CI 0.03 to 0.89, p=0.036) besides the presence of late microvascular obstruction (HR=10.03, 95% CI 0.98 to 102.43, p=0.05) were significantly related to the occurrence of adverse LV remodelling at 4 months.
  
  
  
  Circulating fetuin-A at day 2 after STEMI is related to acute and chronic infarct size, LV function and dimensions. In addition, it might be useful to identify patients at increased risk for adverse LV remodelling.
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Hans-Josef
authors.initials: HJ
authors.lastname: Feistritzer
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Klug
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Sebastian J
authors.initials: SJ
authors.lastname: Reinstadler
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Marie-Therese
authors.initials: MT
authors.lastname: Gröber
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Mair
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kirchmair
authors.affiliation: University Clinic of Radiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Henninger
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Wolfgang-Michael
authors.initials: WM
authors.lastname: Franz
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Innsbruck , Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler