Biomarker insights: Galectin-3 and pentraxin-3 in chronic ischemic heart disease and atrial fibrillation

Chronic ischemic heart disease 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 (Gal3) and pentraxin-3 (PTX3), as potential biomarkers in atherosclerosis, yet their specific interactions and implications in patients with chronic coronary syndrome (CCS) and AF remain underexplored. This study aimed to evaluate the levels of Gal3 and PTX3 in a cohort of patients with CCS and AF, assessing their association with disease severity and clinical outcomes. A total of 131 patients diagnosed with CCS or/and AF were stratified based on coronary stenosis severity (significant, S-CCS: defined as stenosis ≥ 70% for one of the coronary arteries, except for left main where stenosis ≥ 50%) and non-significant, N-CCS coronary lesions: defined as stenosis < 70% for one of the coronary arteries, except for left main where stenosis < 50%) 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 to 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 to 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 increase in those with paroxysmal, persistent and permanent AF, for whom they reach a mean of 3162.87 ± 1893.068 pg/mL. The results are detailed in Table 1 . 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.