Lower Plasma Fetuin-A Levels Are Associated With a Higher Mortality Risk in Patients With Coronary Artery Disease

Objective— The present study was designed to evaluate the association of circulating fetuin-A with cardiovascular disease (CVD) and all-cause mortality. Approach and Results— We measured plasma fetuin-A in 1620 patients using an enzyme-linked immunosorbent assay kit. The patients were members of the Guangdong coronary artery disease cohort and were recruited between October 2008 and December 2011. Cox regression models were used to estimate the association between plasma fetuin-A and the risk of mortality. A total of 206 deaths were recorded during a median follow-up of 5.9 years, 146 of whom died from CVD. The hazard ratios for the second and third tertiles of the fetuin-A levels (using the first tertile as a reference) were 0.65 (95% confidence interval, 0.44–0.96) and 0.51 (95% confidence interval, 0.33–0.78) for CVD mortality ( P =0.005) and 0.65 (95% confidence interval, 0.47–0.91) and 0.48 (95% confidence interval, 0.33–0.70) for all-cause mortality ( P <0.001), respectively. Conclusions— Lower plasma fetuin-A levels were associated with an increased risk of all-cause and CVD mortality in patients with coronary artery disease independently of traditional CVD risk factors.