Galectin-3 and Pentraxin-3 as Potential Biomarkers in Chronic Coronary Syndrome and Atrial Fibrillation: Insights from a 131-Patient Cohort

Abstract

Chronic coronary syndrome (CCS) and atrial fibrillation (AF) are prevalent cardiovascular conditions between whom there is a dual relationship, with significant morbidity and mortality. Recent studies have highlighted the roles of galectin-3 and pentraxin-3 as potential biomarkers in coronary atherosclerosis, yet their specific interactions and implications in patients with CCS and AF remain underexplored. This proof-of-concept study aimed to evaluate the levels of galectin-3 and pentraxin-3 in a cohort of patients with CCS and AF. A total of 131 patients diagnosed with CCS or/and AF were stratified based on coronary stenosis severity (significant, S-CCS and nonsignificant, N-CCS coronary lesions) and arrhythmia burden. Blood samples were collected to measure serum levels of galectin-3 and pentraxin-3 using enzyme-linked immunosorbent assay (ELISA) techniques. Clinical data, including demographic information, comorbidities, medication use, and biological markers of systemic inflammation, were recorded. The galectin-3 value was more than double in patients with S-CCS compared with those with N-CCS (17.39 ± 4.459 ng/mL versus 7.49 ± 2.732 ng/mL, p < 0.001). Atrial fibrillation was not associated with statistically significant variations in galectin-3 values, neither overall nor separately in the group of S-CCS or N-CCS. However, pentraxin-3 values were similar in S-CCS compared with those with N-CCS (2839.18 ± 1521.639 pg/mL versus 2564.07 ± 1299.055 pg/mL, p = 0.417). These values were lower in patients with sinus rhythm, with a mean of 2469.91 ± 1253.782 pg/mL, and steadily increased in those with paroxysmal, persistent, and permanent AF, for whom they reached a mean of 3162.87 ± 1893.068 pg/mL. Elevated levels of galectin-3 appear to correlate with coronary stenosis severity and may inform future strategies for risk stratification, patients' selection for invasive coronarography or therapeutic targeting in CCS.

Keywords: atrial fibrillation; biomarkers; chronic coronary syndrome; coronary ischemic disease; galectin-3; pentraxin-3.

Figure 1

Box Plot of galectin-3 depending on the severity of chronic coronary syndrome and presence/type of atrial fibrillation. AF: atrial fibrillation; CCS: Chronic coronary syndrome; NS-CCS: nonsignificant chronic coronary syndrome; Parox-AF: paroxysmal AF; Pers-AF: persistent AF; Perm-AF: Permanent AF; S-CCS: significant chronic coronary syndrome; SR: sinus rhythm.

Figure 2

Box Plot of pentraxin-3 depending on the severity of chronic coronary syndrome and presence/type of atrial fibrillation. AF: atrial fibrillation; CCS: Chronic coronary syndrome; NS-CCS: nonsignificant chronic coronary syndrome; Parox-AF: paroxysmal AF; Pers-AF: persistent AF; Perm-AF: Permanent AF; S-CCS: significant chronic coronary syndrome; SR: sinus rhythm.

Figure 3

ROC curves expressing the association between specified parameters and the diagnosis of significant chronic coronary syndrome. BMI: body mass index; HDLc: high-density lipoprotein-cholesterol; TRV: tricuspid velocity.