Background: Fetuin-A inhibits inflammation and has a protective effect against myocardial ischemia. We investigated the influence of ischemic postconditioning on serum fetuin-A levels and high-sensitive C-reactive protein (hs-CRP) in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous intervention. Methods: Forty-five patients undergoing percutaneous coronary intervention (PCI) were randomly assigned to a control (n = 21) or postconditioning (PC, n = 24) group within 90 minutes after admission. After predilatation, in the control group, no intervention was applied in the first 3 minutes of reperfusion, while in the postconditioning group, three cycles of 30-second angioplasty balloon deflation and 30-second inflation were repetitively applied. Blood samples were obtained and assayed for creatine kinase MB (CK-MB), fetuin-A and hs-CRP. Results: The control group presented with higher peak CK-MB as compared with the PC group (123.67 +/- 44.19 vs. 93.08 +/- 35.29 U/L, p < 0.05). After PCI, PC was associated with a lower level of hs-CRP in comparison with the control group (6.07 +/- 1.35 vs. 7.03 +/- 1.27 mg/L, p < 0.05). Serum fetuin-A levels in the PC group was higher than in the control (161.06 +/- 23.98 mg/L vs. 144.59 +/- 22.76 mg/L, p < 0.05). Conclusions: Postconditioning may increase serum fetuin-A levels and decrease high-sensitive C-reactive protein in myocardial infarction patients.