Abstract Number: PB1046
Meeting: ISTH 2021 Congress
Background: Atrial fibrillation (AF) is the most diagnosed cardiac arrhythmia in the world. While over 2.7 million Americans have AF, the pathophysiology remains unclear1. Current literature reveals that inflammation and atrial remodeling are integral to AF development2,3.
Aims: This study aims to demonstrate that collagen turnover proteins give a telling narrative of AF progression.
Methods: Baseline citrated blood samples from 91 patients with confirmed diagnosis of AF were collected at Loyola University Medical Center. Normal human plasma (NHP) was obtained from a commercial source (George King Biomedical, Overland Park, KS). Biomarkers of collagen turnover, including MMP-1, MMP-2, TIMP-1, TIMP-2, ICTP, PICP, PINP, PIIICP and PIIINP were measured using commercially available ELISA methods. Results were then statistically analyzed using Graphpad Prism v.8; the results are compiled in Table 1.
Results: Biomarkers including MMP-1 (AF 1.35 ± 0.19, 279% vs 0.36 ± 0.096; p< 0.0001), MMP-2 (AF 263.5 ± 6.4, 38% vs 191.2 ± 21.3; p< 0.02), TIMP-1 (AF 125.9 ± 9.0, 56% vs 80.8 ± 21.4; p< 0.05), TIMP-2 (AF 137.6 ± 4.2, 43% vs 96.3 ± 8.5; p< 0.004), PIIINP (AF 26.4 ± 4.3, 584% vs 3.9 ± 1.2; p< 0.02), and PINP (AF 422.3 ± 43.8, 51% vs 280.5 ± 56.5; p< 0.02) showed significant increase when compared to NHP (Table 1a). Significant correlations were found between TIMP-2 and MMP-1 (0.492; p< 0.0001), PIIINP and TIMP-1 (0.313; p< 0.01), and PIIINP and PINP (0.460, p< 0.001).
Conclusions: These results firmly indicate AF upregulates collagen degradation. While collagen synthesis is not as unanimously demonstrated, the increase of PIIINP and PINP, along with PIIINP’s strong correlation to TIMP-1, strongly suggest an increase in collagen synthesis, as well. Suggesting that collagen turnover is increased in AF patients. These biomarkers can now be reliably used to correlate against other biomarker findings. Additionally, these collagen turnover biomarkers could be studied to determine their accuracy in scoring fibrosis compared to LGE-MRI.
To cite this abstract in AMA style:Wieschhaus K, Bontekoe E, Fareed J, Hoppensteadt D, Mushabbar S, Goldstein J. Collagen Turnover Biomarkers in Atrial Fibrillation and their Use in Clinical Management and the Study of Inflammatory Pathogenesis [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/collagen-turnover-biomarkers-in-atrial-fibrillation-and-their-use-in-clinical-management-and-the-study-of-inflammatory-pathogenesis/. Accessed September 24, 2021.
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