The diagnostic value of determining fibrosis biomarkers in patients with atrial fibrillation and coronary artery disease

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Abstract

Background. The combination of atrial fibrillation (AF) and acute coronary syndrome (ACS) is common in the population and entails increased risks of adverse cardiovascular events and a worse prognosis. Myocardial fibrosis forms the basis of the pathophysiology of both AF and coronary artery disease. Noninvasive fibrosis markers allow for early diagnosis of fibrotic myocardial remodeling and the development of new therapeutic strategies for patient management.

Objective: to assess the association between circulating myocardial fibrosis biomarkers and echocardiographic stiffness parameters in patients with atrial fibrillation (AF) after acute coronary syndrome (ACS).

Methods. A cohort open prospective study was conducted with a total of 66 patients (median age 71.5 [63.8; 77.3] years, 63.6% men) with AF after ACS at least 3 months ago but not more than a year ago. Serum levels of procollagen type I carboxy-terminal propeptide (PICP), procollagen type III N-terminal propeptide (PIIINP), transforming growth factor beta-1 (TGF-β1), galectin-3 (Gal-3) were determined. All patients also underwent routine 2D transthoracic echocardiography and speckle tracking echocardiography. The relationship between laboratory and echocardiographic parameters was analyzed using linear and logistic regression.

Findings. A significant strong positive linear relationship was revealed between the PICP levels and the average left ventricular end-diastolic volume (LVEDV) (R2=0.137, stand. β=0,371), the LVEDV index (R2=0.122, stand. β=0,350), the left ventricular global longitudinal strain (LV GLS) (R2=0.090, stand. β=0,300) and the LV GLS rate (R2=0.069, stand. β=-0,256) (p<0.05 for all). And a significant strong negative linear relationship was revealed between TGF-β1 levels and the left atrial (LA) expansion index (p=0.014, R2=0.094, stand. β=-0.306). During logistic regression, an increase in PIIINP concentration was statistically significantly associated with a decrease in the LP extensibility index (less than the median of 0.3) (Odds Ratio 1.11 (95% Confidence Interval: 1.01–1.21), p=0.018).

Conclusion. The data obtained expand the available limited literature information on the relationship between laboratory and instrumental parameters of LP and LV fibrosis.

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About the authors

Alexey I. Kochetkov

Russian Medical Academy of Continuous Professional Education

Email: ak_info@list.ru
ORCID iD: 0000-0001-5801-3742

Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

Anna V. Dubinina

Russian Medical Academy of Continuous Professional Education

Email: dubinina_anna2023@mail.ru
ORCID iD: 0009-0008-6383-0016

2nd year Postgraduate Student of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

Natalia E. Gavrilova

Russian Medical Academy of Continuous Professional Education; «Scandinavian Health Center» LLC

Email: natysja2004@yandex.ru
ORCID iD: 0000-0003-4624-9189

Dr. Sci. (Med.), Professor of the Department of therapy and multimorbid pathology named after Academician M.S. Vovsi, General Director – Chief Physician of Scandinavian Healthcare

Russian Federation, Moscow; Moscow

Tatyana N. Korotkova

Federal Research Centre of Nutrition and Biotechnology

Email: tntisha@gmail.com
ORCID iD: 0000-0002-3684-9992

Cand. Sci. (Med.), Head of the Laboratory of Clinical Biochemistry, Immunology and Allergology

Russian Federation, Moscow

Ilya V. Vorozhko

Federal Research Centre of Nutrition and Biotechnology

Email: bio455@inbox.ru
ORCID iD: 0000-0003-2529-9152

Cand. Sci. (Med.), Senior research fellow of the Laboratory of Clinical Biochemistry, Immunology and Allergology

Russian Federation, Moscow

Antonina V. Starodubova

Federal Research Centre of Nutrition and Biotechnology; Pirogov Russian National Research Medical University

Email: lechebnoedelo@yandex.ru
ORCID iD: 0000-0001-9262-9233

Dr. Sci. (Med.), Deputy Director for Scientific and Medical Work, Professor

Russian Federation, Moscow; Moscow

Karin B. Mirzaev

Russian Medical Academy of Continuous Professional Education

Email: karin05doc@yandex.ru
ORCID iD: 0000-0002-9307-4994

Dr. Sci. (Med.), Associate Professor, Vice-Rector for Research and Innovation, Director of Research Institute of Molecular and Personalized Medicine, Professor of the Department of Clinical Pharmacology and Therapy named after Academician B.E. Votchal

Russian Federation, Moscow

Olga D. Ostroumova

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-0795-8225
SPIN-code: 3910-6585

Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

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