Abstract
Objective Coronary artery disease (CAD) and associated comorbidities such as heart failure (HF) remain the leading cause of morbidity and mortality worldwide, attributed to, at least partially, the lack of biomarkers for efficient disease diagnosis. The study intended to explore potential biomarkers for predicting the presence of HF in CAD patients. Methods According to the presence of HF, 83 CAD patients with HF were assigned to the AHF group and 52 CAD patients without HF to the CAD group. Additionally, healthy controls (n = 52) were those who had received physical examinations at the same period. The serum levels of IL-13, TGF-β1, and periostin were detected by the enzyme-linked immunosorbent assay (ELISA). Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricle-end diastolic volume (LVEDV), and left ventricular mass index (LVMI) were detected 3 times by color Doppler ultrasound. The predictive values of IL-13, TGF-β1, and periostin methods were compared by receiver-operating characteristic (ROC) analysis and the area under the curve (AUC). Results Increased levels of IL-13, TGF-β1, and periostin were noted in the AHF group than in the control and CAD groups (p < 0.001); the CAD group showed higher levels of IL-13, TGF-β1, and periostin than the control group (p < 0.001). Based on the NYHA classification, there were 33 cases with grade II, 28 cases with grade III, and 22 cases with grade IV among 83 CAD patients with HF. It was found that the serum levels of IL-13, TGF-β1, and periostin were higher in the AHF-IV group than in the AHF-III and AHF-II groups (p < 0.001); these levels were also higher in the AHF-III group than in the AHF-II group (p < 0.001). The periostin level was positively correlated with the levels of IL-13 (r = 0.458) and TGF-β1 (r = 0.569) in CAD patients with AHF. Besides, the serum levels of periostin (r = -0.425), IL-13 (r = -0.341), and TGF-β1 (r = -0.435) were negatively correlated with the LVEF of CAD patients with AHF, respectively. When IL-13, TGF-β1, and periostin levels were used to predict the presence of AHF in CAD patients in combination, the sensitivity and specificity were 75.9% and 90.38%, respectively, with the AUC of 0.906 (95% CI: 0.912–0.996). Conclusion These data reveal that IL-13, TGF-β1, and periostin levels might be associated with the occurrence of AHF in CAD patients and their combination shows the predictive value for the presence of AHF in CAD patients.
Highlights
Coronary artery disease (CAD), known as coronary heart disease (CHD), is a cardiovascular disease
Age, body mass index, smoking status, HR, ALT, AST, creatinine, and blood urea nitrogen (BUN) among acute HF (AHF), CAD, and control groups are shown in Table 1. e three groups were comparable considering no significant difference in baseline characteristics (p > 0.05)
With regard to cardiac function, it was found that left ventricular end-diastolic dimension (LVEDD), left ventricle-end diastolic volume (LVEDV), and left ventricular mass index (LVMI) were increased, but Left ventricular ejection fraction (LVEF) was decreased in the AHF group compared to the control and CAD groups (p < 0.001)
Summary
Coronary artery disease (CAD), known as coronary heart disease (CHD), is a cardiovascular disease. It refers to the formation of atherosclerotic plaques in the blood vessels that provide oxygen and nutrition to the heart and are mainly manifested in four forms involving stable angina pectoris, unstable angina pectoris, myocardial infarction, or sudden cardiac death [1, 2]. E World Health Organization reported that 17.3 million deaths were related to cardiovascular diseases in 2008, of which CAD accounted for a large proportion [4]. It was reported that CAD was one of the major causes of mortality and morbidity in India, especially in south India, which might
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