Differential Regulation of Inflammatory and Pro-Resolving Lipid Mediators in Chronic Coronary Syndrome Across Cardiometabolic Phenotypes

Chronic coronary syndrome (CCS) is characterized by persistent low-grade inflammation and impaired resolution of inflammatory responses within the vascular wall. Specialized pro-resolving mediators (SPMs), including resolvins and maresins, play an essential role in terminating inflammation and restoring tissue homeostasis. This prospective observational study included 83 patients hospitalized due to stable angina or angina-equivalent symptoms. Serum concentrations of leukotriene B4 (LTB4), maresin-1 (MaR1), resolvin E1 (RvE1), resolvin D1 (RvD1), and prostaglandin E2 (PGE2) were determined using enzyme-linked immunosorbent assays. Associations between mediator concentrations and clinical characteristics—including sex, age, and body mass index (BMI)—were analyzed using nonparametric statistical tests with false-discovery-rate correction. Women, patients ≥65 years of age, and individuals with BMI ≥ 30 kg/m2 demonstrated significantly higher concentrations of LTB4, MaR1, and RvD1. In contrast, higher RvE1 concentrations were observed in men, younger patients, and those with a BMI < 30 kg/m2. PGE2 levels did not differ significantly between the analyzed subgroups. Multivariable analysis identified age, LTB4, and RvD1 as independent predictors associated with coronary artery disease in the studied cohort. Circulating lipid mediator profiles differ according to sex, age, and obesity status in patients with chronic coronary syndrome. These findings demonstrate differential circulating lipid mediator profiles associated with age, sex, and obesity in patients with chronic coronary syndrome. Whether these profiles reflect adaptive inflammatory resolution or impaired resolution requires further investigation.