Fetuin-A levels in association with calcific aortic valve disease: A meta-analysis

Background and aims: Calcific aortic valve disease (CAVD) is a common valvular disease, prevalent particularly within the older age groups. The potential use of biomarkers in diagnosing and assessing the severity of CAVD, in supplementation with imaging techniques, has recently gained momentum within the field of cardiovascular medicine. Therefore, a meta-analysis was performed that assessed the association between the fetuin-A levels, and the presence of CAVD. Methods: PubMed and Cochrane were searched from inception to April 2023. Risk of bias was assessed using the Newcastle-Ottawa scale for cohort studies. Results: This analysis includes a total of 3,280 patients with CAVD, and 7,505 patients as control, resulting in the pooling of 10,785 patients in this meta-analysis. It was observed that the circulating levels of fetuin-A were significantly lowered in patients with CAVD (SMD:-0.20; 95% CI:-0.39,-0.02; P = 0.03). Moreover, the analysis revealed that fetuin-A levels had no significant association with CAVD in patients suffering from kidney disease (SMD: 0.20; 95% CI:-0.46, 0.85; P = 0.56). Conclusion: While initial results demonstrate the potential effectiveness, further research is essential in order to arrive at a robust conclusion regarding the use of fetuin-A as a diagnostic biomarker for calcific aortic valve disease.