Association of fetuin-A and heat shock protein 70 with arterial calcification in patients with peripheral vascular disease

Abstract Atherosclerosis may present with arterial calcification, which is associated with increased cardiovascular morbidity and mortality. Fetuin-A plays a role in the inhibition of extraosseal calcification, and heat shock protein 70 (Hsp70) is elevated in peripheral artery disease. The aim of our study was to examine the potential role of fetuin-A and Hsp70 in the inhibition of arterial calcification in atherosclerotic patients. Classical risk factors of atherosclerosis as well as the severity of arterial calcification and atherosclerosis were assessed by ultrasound, angiography, and serum analysis in a cross-sectional study of patients with carotid stenosis, aortic aneurysm, and lower extremity atherosclerosis. We demonstrate that there is an inverse correlation between serum fetuin-A levels and the severity of arterial calcification in patients with chronic atherosclerotic lower extremity disease without renal disease or infection. Our data suggest that it is not end-stage renal disease and dialysis that explains the earlier reported association of low fetuin-A level and arterial calcification. The novel finding of our study is the significantly different serum fetuin-A levels in patients with aortic aneurysm of different etiologies (atherosclerosis and Marfan syndrome). Our results suggest that there is an association between serum fetuin-A levels and the severity of arterial calcification also in patients without renal failure.