Lipid exchange and inflammatory markers in patients with coronary artery disease and atrial fibrillation
DOI:
https://doi.org/10.34287/MMT.3(58).2023.4Abstract
Aim. To investigate lipid exchange violations, inflammatory markers levels, their connections in coronary artery disease (CAD) patients with atrial fibrillation (AF) and their role in AF paroxysm development and duration.
Materials and methods. 300 patients were divided into three groups: 27 patients without CAD and arrhythmias formed the control group (CG), 149 patients with CAD but without arrhythmias were included in the main group, and 124 patients with CAD and AF paroxysm were in the comparison group. The average duration of AF paroxysm in the studied group was 2 [1; 3] days (mean [95 % CI]). Such indexes were examined: total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL), high-density lipoprotein (HDL), lipoprotein (α) (Lp(α)), apolipoprotein A1 (ApoA1), apoprotein B (ApoB), C-reactive protein (CRP) and interleukin 6 (IL-6).
Results. According to our data, CAD is characterized by significant lipid exchange violations (increasing TC, LDL, TG, Lpα, ApoB and decreasing HDL; p < 0.05) and increasing inflammatory markers (CRP, IL-6). The presence of AF paroxysm in CAD patients deepened such changes (increasing ApoB, IL-6, CRP; p < 0.05) and ApoB/ApoA1 ratio was increased (p < 0.05). Significant strong and middle strength correlations between inflammatory markers (CRP, IL-6) and lipid exchange indexes (LDL, TG, ApoA1, ApoB, ApoB/ApoA1) were found (p < 0.05). For validation the role of lipid exchange and inflammation in AF pathogenesis ROC curve was performed: LDL + 1.6 × CRP, the area under ROC curve 0.8519 (p < 0.05). This formula can help us to predict the development of AF paroxysm in CAD patients. Moreover, a linear regression equation was created: AF Paroxysm Duration (days) = 0.91 × IL-6 – 0.95 (p < 0.05), which will help to predict AF paroxysm duration in CAD patients, too.
Conclusions. AF paroxysm occurrence in CAD patients is based on dyslipidemia and inflammation. It is connected with increasing IL-6, CRP, ApoB/ApoA1 levels. The duration of AF paroxysm in CAD patients directly depends on the IL-6 level.
References
Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et.al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020 Jan 14;41(3):407-477. doi: 10.1093/ eurheartj/ehz425.
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et.al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373-498. doi: 10.1093/eurheartj/ehaa612.
Michniewicz E, Mlodawska E, Lopatowska P, Tomaszuk-Kazberuk A, Malyszko J. Patients with atrial fibrillation and coronary artery disease - Double trouble. Adv Med Sci. 2018;63(1):30-5. doi: 10.1016/j.advms.2017.06.005.
Balamurugan V, Maradi R, Joshi V, Shenoy BV, Goud MBK. Dyslipidaemia and inflammatory markers as the risk predictors for cardiovascular disease in newly diagnosed premenopausal hypothyroid women. J Med Biochem. 2023;42(1):58-66. doi: 10.5937/jomb0-37007.
Chen M, Fang CY, Guo JC, Pang LM, Zhou Y, Hong Y, et.al. Predictive value of atherogenic index of plasma and atherogenic index of plasma combined with low-density lipoprotein cholesterol for the risk of acute myocardial infarction. Front Cardiovasc Med. 2023;10:1117362. doi: 10.3389/ fcvm.2023.1117362.
Scheff SW. Fundamental statistical principles for the neurobiologist: a survival guide. Amsterdam: Academic Press is an imprint of Elsevier; 2016.
Mandrekar JN Receiver operating characteristic curve in diagnostic test assessment. J Thor Oncol, 2010;5(9):1315-6. 10.1097/JTO.0b013e- 3181ec173d.
Molina CR, Mathur A, Soykan C, Sathe A, Kunhiraman L. Risk Factor Interactions, Non-High-Density Lipoprotein Cholesterol to Apolipoprotein B Ratio, and Severity of Coronary Arteriosclerosis in South Asian Individuals: An Observational Cohort Study. J Am Heart Assoc. 2023 16;12(10):e027697. doi: 10.1161/JAHA.122.027697.
Dong H, Wang J, Hu P, Lu N. Association of Apolipoprotein A1, High Density Lipoprotein Cholesterol, and Their Ratio with Inflammatory Marker in Chinese Adults with Coronary Artery Disease. Angiology. 2023;74(8):765-73. doi: 10.1177/00033197221121002.
Yang S, Pudasaini R, Zhi H, Wang L. The Relationship between Blood Lipids and Risk of Atrial Fibrillation: Univariable and Multivariable Mendelian Randomization Analysis. Nutrients. 2021 Dec 31;14(1):181. doi: 10.3390/ nu14010181.
Zhong X, Jiao H, Zhao D, Teng J. Association between serum apolipoprotein B and atrial fibrillation: a case-control study. Sci Rep. 2022;12(1):9597. doi: 10.1038/s41598-022-13773-2.
Zhong X, Jiao H, Zhao D, Teng J, Yang M. Case-Control Study to Investigate the Association Between Serum Apolipoprotein B/A1 Ratio and Atrial Fibrillation by Sex in 920 Patients from China. Med Sci Monit. 2022;28:e936425. doi: 10.12659/MSM.936425.
Tajik B, Tuomainen TP, Jarroch R, Kauhanen J, Lip GYH, Isanejad M. Lipid levels, apolipoproteins, and risk of incident atrial fibrillation in men: A report from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD). J Clin Lipidol. 2022;16(4):447-54. doi: 10.1016/j.jacl.2022.04.003.
Liao J, Zhang S, Yang S, Lu Y, Lu K, Wu Y, et al. Interleukin-6-Mediated-Ca2+ Handling Abnormalities Contributes to Atrial Fibrillation in Sterile Pericarditis Rats. Front Immunol. 2021;12:758157. doi: 10.3389/fimmu.2021.758157.
Wu Q, Liu H, Liao J, Zhao N, Tse G, Han B, et al. Colchicine prevents atrial fibrillation promotion by inhibiting IL-1β-induced IL-6 release and atrial fibrosis in the rat sterile pericarditis model. Biomed Pharmacother. 2020;129:110384. doi: 10.1016/j.biopha.2020.110384.