Avaliação dos parâmetros cardiovasculares e sua associação com marcadores hemostáticos, inflamatórios e de estresse oxidativo em pacientes com fibrilação atrial.

Abstract

Atrial fibirllation is is a supraventricular arrhythmia, whose pathophysiology can be considered multifactorial. Due to the changes caused by AF, individuals are at increased risk of thromboembolism, making therapeutic anticoagulation essential for promoting the quality of life of these patients. In this context, the objective of this study was to evaluate new cardiovascular biomarkers and their association with hemostatic, inflammatory, and oxidative stress markers in patients with atrial fibrillation using rivaroxaban (n=29) or warfarin (n=45), compared to a control group without atrial fibrillation (n=62). Specific measurements of each biomarker were performed using the LUMINEX panel. The results showed that the AF group, compared to the controls, had significantly higher median levels of BNP and NT-proBNP (p=0.035), as well as endocan-1 (p=0.001), while PIGF levels were lower in this group (p=0.049). There were no significant differences between the groups regarding the other biomarkers—CXCL6, CXCL16, and OSM—with p-values of 0.820, 0.143, and 0.400, respectively. AF participants using warfarin showed higher serum levels of BNP (p=0.022) compared to the control group, while PIGF levels were higher among control group participants (p=0.045). Endocan levels were significantly higher in the group anticoagulated with rivaroxaban (p=0.005) and warfarin (p=0.016). Regular physical activity showed a positive influence, contributing to a 53.8% reduction in NT-proBNP levels, while advancing age was associated with a 0.97% increase in the endothelial injury biomarker, endocan. Correlations were identified between cardiovascular biomarkers, inflammatory parameters, and lipid profile, including: a positive and weak correlation between BNP and NTproBNP (r= 0.38 p = 0.001), moderate positive correlation (0.46; p < 0.001) between NT-proBNP and PIGF, as well as between IP-10 and endocan (0.40; p = 0.002). Lastly, a moderate negative correlation was found between endocan and cholesterol (-0.40; p = 0.001). Based on these findings, endothelial injury was associated with AF and identified as a potential marker for predicting disease occurrence and progression. The results highlight endothelial injury as a contributing factor in the pathophysiology of AF, pointing to opportunities for innovation in the prevention, treatment, and management of patients with this arrhythmia.