Objective: Fetuin-A is an acidic glycoprotein produced in the liver, as an inhibitor for cysteine protease. Its gene is founded in chromosome 3 (3q27). It is involved in various physiological and pathological conditions. These include vascular decalcification, bone metabolism, insulin resistance, protease function control, neurological illnesses and multiplication of breast cancer cells. Vascular calcifications predict cardiovascular disease which can be a major cause of death. So, fetuin-A is a potent circulating calcification inhibitor. Studies on individuals with clinical cardiovascular disease supported that lower levels of fetuine-A are released with coronary artery circulation (CAC) and the function of the heart valve. Our aim was to evaluate fetuin-A values of the patients with coronary artery disease, as a prognostic factor of the disease, in correlation with SPET myocardium scintigraphy.
Patients and methods: We studied 40 patients, 25 male and 15 female, with a mean age 48±8 years (range 36 to 69), with coronary heart disease. All were subjected to myocardium scintigraphy, in the Nuclear Medicine Department of University Hospital of Alexandroupolis. Simultaneously, blood samples were drawn for the determination of fetuin-A. Serum fetuin-A levels were measured by a commercially available sandwich ELISA (Epitope Diagnostics, Inc., San Diego, CA).
Results: The average values of fetuin-A range between 140-297mg/L, as it is derived from the current bibliography and our laboratory tests. In normal individuals, pathological values were considered to be under 140mg/L. Twenty five patients with positive SPET imaging for myocardium necrosis (scars) had low fetuin values (45-148mg/ L), 10 of them passing away within 6 months, while the rest of them were showing an encumbered clinical condition (P<0.005). Ten patients with reversible ischemia showed relatively low values (125-302mg/L) (P<0.005). Five patients with a normal myocardiac scintigraphic imaging showed normal values of fetuin-A (165-508mg/L) (P<0.005).
Conclusions: Patients with myocardium necrosis demonstrated very low values of fetuin. Patients with ischemia show low amounts while patients with negative Scintigraphy for ischemia showed normal results of fetuin. The 10 patients that passed away in 6 months showed very low amounts of fetuin. Fetuin-A is supported to be a reliable prognostic factor in monitoring patients with coronary heart disease.