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Serum fetuin-A levels are associated with vascular calcifications and predict cardiovascular events in renal transplant recipients.


ABSTRACT: BACKGROUND AND OBJECTIVES: Vascular calcifications predict cardiovascular disease, the major cause of death in renal transplant recipients (RTRs). We studied the determinants of fetuin-A, a potent circulating calcification inhibitor encoded by the AHSG gene, and tested its association with vascular calcifications and long-term survival and cardiovascular events (CVEs) in RTRs. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Two hundred seventy-seven prevalent RTRs from a single center were included. CVEs and deaths were prospectively recorded during a 5-year follow-up. RESULTS: Independent determinants of lower serum fetuin-A levels were lower plasma cholesterol, the AHSG rs4918 G allele, and history of smoking. Low serum fetuin-A level was a determinant of aortic calcifications (assessed using spiral CT). Low fetuin-A levels (?0.47 g/L, first quintile) were independently associated with CVEs and deaths (hazard ratio=1.83; 95% confidence interval, 1.07 to 3.04). The association was confirmed for all-cause mortality, and the major adverse cardiovascular endpoints were analyzed separately. Patients with low fetuin-A and high high-sensitivity C-reactive protein (>4.36 mg/L, fourth quintile) levels had a 3.5-fold increased risk of all-cause mortality and CVEs. In the presence of inflammation, CVE-free survival was influenced by common variants in the AHSG gene. CONCLUSIONS: These data show that low fetuin-A levels are independently associated with aortic calcifications and a higher risk of CVEs and mortality. They support fetuin-A as a circulating biomarker able to identify RTRs at risk for vascular calcifications and CVEs.

SUBMITTER: Marechal C 

PROVIDER: S-EPMC3087793 | biostudies-literature | 2011 May

REPOSITORIES: biostudies-literature

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Serum fetuin-A levels are associated with vascular calcifications and predict cardiovascular events in renal transplant recipients.

Maréchal Céline C   Schlieper Georg G   Nguyen Pauline P   Krüger Thilo T   Coche Emmanuel E   Robert Annie A   Floege Jorgen J   Goffin Eric E   Jadoul Michel M   Devuyst Olivier O  

Clinical journal of the American Society of Nephrology : CJASN 20110428 5


<h4>Background and objectives</h4>Vascular calcifications predict cardiovascular disease, the major cause of death in renal transplant recipients (RTRs). We studied the determinants of fetuin-A, a potent circulating calcification inhibitor encoded by the AHSG gene, and tested its association with vascular calcifications and long-term survival and cardiovascular events (CVEs) in RTRs.<h4>Design, setting, participants, & measurements</h4>Two hundred seventy-seven prevalent RTRs from a single cente  ...[more]

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