Patients with atrial fibrillation (AF) have a distinct clinical risk profile than those without the condition. The study's goal was to determine whether there were any variations in blood biomarkers between males and females with paroxysmal AF to understand the pathophysiological differences between the two genders.
Overall, 364 patients were enrolled in the discovery cohort study, the risk profile identification to guide atrial fibrillation therapy (AF-RISK) study, and evaluation of the gender differences in 92 blood biomarkers was carried out. The results were evaluated using enrichment pathway analysis and multivariable logistic regression.
Among the patients included in the validation cohort, 213 patients confirmed the results of reappraisal of AF (interaction between vascular destabilization HyperCoagulability and electrical remodeling) in the Progression of AF (RACE V) study. Meanwhile, in the discovery cohort study, 41% of participants were women, and the mean age of study participants was 59 ± 12 years.
Moreover, the CHA2DS2-VASc-score noted was 1.6 ± 1.4. Overall, 50% had heart failure, with preserved ejection fraction (47%) primarily, 46% patients had hypertension, and 10% had diabetes. Furthermore, the fatty acid-binding protein-4 (FABP-4) and activated leukocyte cell adhesion molecule (ALCAM) were higher in women. At the same time, C-C motif chemokine-16 (CCL-16), matrix metalloproteinase-3 (MMP-3), and myoglobin were higher in men.
On the other hand, in validation-cohort, four biomarkers out of the five were confirmed; specifically, adhesion biological pathways [false discovery rate (FDR) = 1.23 × 10-8], and levels of FABP-4 (P = 2.46 × 10-7) and ALCAM (P = 1.73 × 10-4) were recorded to be greater in women. Whereas, levels of markers for extracellular matrix degradation biological pathways (FDR = 3.59 × 10-9), myoglobin (P = 2.10 × 10-4), and MMP-3 (P = 4.31 × 10-8) were greater in men.
The findings lend credence to the clinical idea that the pathophysiological processes of atrial fibrillation in women and men may be different.