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

A.I. Kochetkov, A.V. Dubinina, N.E. Gavrilova, T.N. Korotkova, I.V. Vorozhko, A.V. Starodubova, K.B. Mirzaev, O.D. Ostroumova

1) Russian Medical Academy of Continuous Professional Education, Moscow, Russia; 2) «Scandinavian Health Center» LLC, Moscow, Russia; 3) Federal Research Centre of Nutrition and Biotechnology, Moscow, Russia; 4) Pirogov Russian National Research Medical University, Moscow, Russia

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, Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; ak_info@list.ru, ORCID: https://orcid.org/0000-0001-5801-3742
Anna V. Dubinina, 2nd year Postgraduate Student of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia; dubinina_anna2023@mail.ru,
ORCID: https://orcid.org/0009-0008-6383-0016
Natalia E. Gavrilova, Dr. Sci. (Med.), Professor of the Department of therapy and multimorbid pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; General Director – Chief Physician of Scandinavian Healthcare Center LLC, Moscow, Russia;
natysja2004@yandex.ru, ORCID: https://orcid.org/0000-0003-4624-9189
Tatyana N. Korotkova, Cand. Sci. (Med.), Head of the Laboratory of Clinical Biochemistry, Immunology and Allergology, Federal Research Centre of Nutrition and Biotechnology, Moscow, Russia; tntisha@gmail.com, ORСID: https://orcid.org/0000-0002-3684-9992
Ilya V. Vorozhko, Cand. Sci. (Med.), Senior research fellow of the Laboratory of Clinical Biochemistry, Immunology and Allergology, Federal Research Centre of Nutrition and Biotechnology, Moscow, Russia; bio455@inbox.ru; ORCID: https://orcid.org/0000-0003-2529-9152
Antonina V. Starodubova, Dr. Sci. (Med.), Deputy Director for Scientific and Medical Work, Federal Research Centre of Nutrition and Biotechnology; Professor, Pirogov Russian National Research Medical University, Moscow, Russia; lechebnoedelo@yandex.ru, ORCID: https://orcid.org/0000-0001-9262-9233
Karin B. Mirzaev, 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 Medical Academy of Continuous Professional Education, Moscow, Russia; karin05doc@yandex.ru, ORCID: https://orcid.org/0000-0002-9307-4994
Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; ostroumova.olga@mail.ru, ORCID: https://orcid.org/0000-0002-0795-8225; eLibrary SPIN: 3910-6585 (corresponding author)

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