High baseline fetuin-A levels are associated with lower atherosclerotic plaque progression as measured by 3D ultrasound

Philip Sommer; Michael Schreinlechner; Maria Noflatscher; Daniela Lener; Fabian Mair; Markus Theurl; Rudolf Kirchmair; Peter Marschang

doi:10.1016/j.athplu.2021.09.001

High baseline fetuin-A levels are associated with lower atherosclerotic plaque progression as measured by 3D ultrasound

Atheroscler Plus. 2021 Sep 21:45:10-17. doi: 10.1016/j.athplu.2021.09.001. eCollection 2021 Nov.

Authors

Philip Sommer¹, Michael Schreinlechner², Maria Noflatscher², Daniela Lener², Fabian Mair², Markus Theurl², Rudolf Kirchmair², Peter Marschang²

Affiliations

¹ Department of Internal Medicine I (Gastroenterology, Hepatology and Endocrinology), Medical University of Innsbruck, Anichstraße. 35, A-6020, Innsbruck, Austria.
² Department of Internal Medicine III (Cardiology, Angiology), Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria.

Abstract

Background and aims: The glycoprotein fetuin-A has anti-inflammatory effects, increases insulin resistance and plays an important role in calcium metabolism. The aim of our study was to assess the predictive value of fetuin-A on atherosclerotic plaque progression in comparison to the established cardiovascular biomarker high sensitivity C-reactive protein (hsCRP).

Methods: In this prospective, single center-, cohort study, we included 194 patients with at least one cardiovascular risk factor or established cardiovascular disease (CVD). Over a period of 4 years, each patient underwent 3D plaque volumetry of the carotid and femoral arteries on a yearly basis. To evaluate the predictive value of biomarkers in terms of plaque progression, the baseline values of fetuin-A and hsCRP were correlated with the plaque progression from baseline to the last follow up visit.

Results: 171 patients were included in the final analysis. Baseline fetuin-A levels showed a significant negative correlation with plaque progression (r = -0.244; p = 0.001). In contrast, baseline hsCRP levels showed no correlation with plaque progression (r = 0.096, p = 0.20). In the ROC-analysis, fetuin-A had a significantly better predictive value than hsCRP (fetuin-A AUC 0.67; p = 0.001 vs hsCRP AUC 0.49; p = 0.88) with an optimal cut-off value at 712 μg/ml. In patients with high fetuin A levels (>712 μg/ml), a significantly lower plaque progression was observed compared to the group with low fetuin-A levels <712 μg/ml (high fetuin-A 197 mm³ vs. low fetuin-A 279 mm³; p = 0.01).

Conclusions: Higher fetuin-A levels appear to predict lower atherosclerotic plaque progression in patients with or at risk of cardiovascular disease.

Keywords: 3D ultrasonography; 3D, three-dimensional; ABI, ankle-brachial-index; Atherosclerosis; CBVD, cerebrovascular disease; CPP, carotid plaque progression; CPV, carotid plaque volume; CVD, cardiovascular diseases; CVRF, cardiovascular risk factor; FPP, femoral plaque progression; FPV, femoral plaque volume; FRS, Framingham Risk Score; Fetuin A; IMT, intima media thickness; PAD, peripheral arterial disease; PWV, pulse wave velocity; SD, standard deviation; TPP, total plaque progression; TPV, total plaque volume; hsCRP, high sensitivity C-reactive protein.