Lipid exchange and inflammatory markers in patients with coronary artery disease and atrial fibrillation

Abstract

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.