Correlation analysis of serum sTREM-1 and sHLA-DR levels with the prognosis of patients with atrial fibrillation

Serum sTREM-1 and sHLA-DR in prognosis of AF

  • Anqi Guo Department of Emergency and Critical Care, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
  • Jiayi Zhu Cardiovascular Internal Medicine Department, The First Affiliated Hospital of Zhengzhou University
  • Liqun Zhao Department of Emergency and Critical Care, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
DOI: https://doi.org/10.5937/jomb0-65641
Keywords: Atrial fibrillation, Serum sTREM-1s, Serum sHLA-DR, Prognosis analysis

Abstract


[Objective] To observe the expression levels of serum soluble Triggering Receptor Expressed on Myeloid cells-1 (sTREM-1) and serum soluble Human Leukocyte Antigen-DR (sHLA-DR) in patients with atrial fibrillation (AF) and their clinical significance.

[Methods] 136 patients with atrial fibrillation who were admitted from April 2023 to September 2025 were selected as the research group, and 100 healthy individuals who underwent physical examinations during the same period were selected as the control group. The serum levels of sTREM-1 and sHLA-DR were detected by ELISA, and the serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) were measured by an automatic biochemical analyzer.

[Results] The study group exhibited elevated blood levels of sTREM-1 and sHLA-DR in comparison to the control group (P < 0.05). Regarding patient age, sex, type of atrial fibrillation, and EHRA classification, there were statistically significant variations in the blood levels of sTREM-1 and sHLA-DR between the study group and the control group (P < 0.05). The study group had greater levels of CRP and serum IL-6 than the control group (P < 0.05). The expression levels of sTREM-1 and sHLA-DR in the serum were shown to be favorably linked with those of IL-6 and CRP (P < 0.05) using Pearson correlation analysis. Serum levels of the inflammatory markers IL-6 and CRP, as well as sTREM-1 and sHLA-DR, were found to be strongly associated with AF, according to the results of the logistic regression analysis.

[Conclusion] Serum levels of sTREM-1 and sHLA-DR are increased in patients with atrial fibrillation, which may be related to the onset and progression of AF. Clinically, these can be considered relevant biological indicators for monitoring the condition of AF.

References

1.Bizhanov KA, Аbzaliyev KB, Baimbetov AK, Sarsenbayeva AB, Lyan E. Atrial fibrillation: Epidemiology, pathophysiology, and clinical complications (literature review). J Cardiovasc Electrophysiol. 2023 Jan;34(1):153-165. doi: 10.1111/jce.15759. Epub 2022 Dec 9. PMID: 36434795.
2.Chyou JY, Barkoudah E, Dukes JW, Goldstein LB, Joglar JA, Lee AM, Lubitz SA, Marill KA, Sneed KB, Streur MM, Wong GC, Gopinathannair R; American Heart Association Acute Cardiac Care and General Cardiology Committee, Electrocardiography and Arrhythmias Committee, and Clinical Pharmacology Committee of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular and Stroke Nursing; and Stroke Council. Atrial Fibrillation Occurring During Acute Hospitalization: A Scientific Statement From the American Heart Association. Circulation. 2023 Apr 11;147(15):e676-e698. doi: 10.1161/CIR.0000000000001133. Epub 2023 Mar 13. Erratum in: Circulation. 2023 Apr 25;147(17):e717. doi: 10.1161/CIR.0000000000001147. PMID: 36912134.
3.Bidaoui G, Assaf A, Marrouche N. Atrial Fibrillation in Heart Failure: Novel Insights, Challenges, and Treatment Opportunities. Curr Heart Fail Rep. 2024 Nov 22;22(1):3. doi: 10.1007/s11897-024-00691-9. PMID: 39572434; PMCID: PMC11582326.
4.Karakasis P, Theofilis P, Vlachakis PK, Korantzopoulos P, Patoulias D, Antoniadis AP, Fragakis N. Atrial Fibrosis in Atrial Fibrillation: Mechanistic Insights, Diagnostic Challenges, and Emerging Therapeutic Targets. Int J Mol Sci. 2024 Dec 30;26(1):209. doi: 10.3390/ijms26010209. PMID: 39796066; PMCID: PMC11720255.
5.Varrias D, Saralidze T, Borkowski P, Pargaonkar S, Spanos M, Bazoukis G, Kokkinidis D. Atrial Fibrillation and Dementia: Pathophysiological Mechanisms and Clinical Implications. Biomolecules. 2024 Apr 8;14(4):455. doi: 10.3390/biom14040455. PMID: 38672471; PMCID: PMC11048426.
6.Li H, Feng Z, Li B, Bai J, Lin QY, Yu X, Zhang N, Xie Y, Yang X. GSTP1 inhibits angiotensin II-induced atrial fibrillation by regulating ferroptosis. Europace. 2025 May 7;27(5):euaf083. doi: 10.1093/europace/euaf083. PMID: 40186487; PMCID: PMC12095811.
7.Smith EE, Yaghi S, Sposato LA, Fisher M. Atrial Fibrillation Detection and Load: Knowledge Gaps Related to Stroke Prevention. Stroke. 2024 Jan;55(1):205-213. doi: 10.1161/STROKEAHA.123.043665. Epub 2023 Nov 21. PMID: 38134250.
8.Bukhari S, Khan SZ, Bashir Z. Atrial Fibrillation, Thromboembolic Risk, and Anticoagulation in Cardiac Amyloidosis: A Review. J Card Fail. 2023 Jan;29(1):76-86. doi: 10.1016/j.cardfail.2022.08.008. Epub 2022 Sep 17. PMID: 36122817.
9.Sadat B, Al Taii H, Sabayon M, Narayanan CA. Atrial Fibrillation Complicating Acute Myocardial Infarction: Prevalence, Impact, and Management Considerations. Curr Cardiol Rep. 2024 May;26(5):313-323. doi: 10.1007/s11886-024-02040-7. Epub 2024 Mar 14. PMID: 38483761.
10.Saksena S, Slee A, Nagarakanti R, Atul Prakash. Atrial Fibrillation (AF) and Heart Failure With Preserved Ejection Fraction (HFpEF): Advances and Challenges. J Cardiovasc Electrophysiol. 2025 Oct;36(10):2720-2745. doi: 10.1111/jce.16625. Epub 2025 Mar 10. PMID: 40065549; PMCID: PMC12530680.
11.Yu C, Jiang L, Long L, Yu H. Atrial fibrillation in cancer patients: Epidemiology, identification and management. Semin Cancer Biol. 2025 Jun;111:39-47. doi: 10.1016/j.semcancer.2025.02.006. Epub 2025 Feb 22. PMID: 39993515.
12.Aggarwal K, Valleru PS, Anamika FNU, Aggarwal P, Gupta I, Gupta V, Garg N, Jain R. Unraveling the Complex Relationship-Atrial Fibrillation and Pulmonary Hypertension. Curr Cardiol Rep. 2024 Sep;26(9):885-891. doi: 10.1007/s11886-024-02089-4. Epub 2024 Jul 10. PMID: 38985227.
13.Habel N, Infeld M, Lustgarten D, Meyer M. Atrial fibrillation and heart failure with preserved ejection fraction "twindemic"-Shared root causes and treatment targets. Heart Rhythm. 2025 May;22(5):1188-1196. doi: 10.1016/j.hrthm.2024.08.064. Epub 2024 Sep 6. PMID: 39245253.
14.Spitz AZ, Zeitler EP. Atrial Fibrillation Ablation in Heart Failure with Reduced Ejection Fraction. Card Electrophysiol Clin. 2025 Mar;17(1):43-52. doi: 10.1016/j.ccep.2024.08.005. Epub 2024 Oct 2. PMID: 39893036.
15.Campbell LA, Ammon JP, Kombathula R, Muhammad N, Jackson CD. New atrial fibrillation guideline: Modify risk, control rhythm, prevent progression. Cleve Clin J Med. 2025 May 1;92(5):291-296. doi: 10.3949/ccjm.92a.24067. PMID: 40312119.
16.Capucci A, Reiffel JA. Atrial fibrillation progression: another step in the RACE to full understanding. Europace. 2023 May 19;25(5):euad071. doi: 10.1093/europace/euad071. PMID: 36967477; PMCID: PMC10227756.
17.Curcio A, Quarta R. Transesophageal echocardiography before atrial fibrillation ablation: to do or not to do? Kardiol Pol. 2024;82(5):477-479. doi: 10.33963/v.phj.100588. Epub 2024 May 20. PMID: 38767169.
18.Homoud M. Ablation for Persistent Atrial Fibrillation: Is There a Light at the End of the Tunnel? J Am Heart Assoc. 2023 Sep 5;12(17):e031258. doi: 10.1161/JAHA.123.031258. Epub 2023 Aug 29. PMID: 37642025; PMCID: PMC10547349.
19.Khairy P, Macle L, Nattel S. Atrial Tachycardia and Atrial Fibrillation in Congenital Heart Disease: Coexistence or Causality? JACC Clin Electrophysiol. 2024 Jun;10(6):1061-1063. doi: 10.1016/j.jacep.2024.03.041. PMID: 38925719.
20.Del Monte A, Sarkozy A, Verbrugge FH. Atrial Fibrillation Management with Guideline-Directed Medical Therapy and Comorbidity Treatment in Heart Failure Patients. Card Electrophysiol Clin. 2025 Mar;17(1):63-73. doi: 10.1016/j.ccep.2024.09.001. Epub 2024 Nov 16. PMID: 39893038.
21.Haverkamp W, Sittner W, Haverkamp A, Knebel F. Alternative Behandlungsverfahren bei Vorhofflimmern : Was bringt Yoga? [Alternative treatment strategies for atrial fibrillation : Benefits from yoga?]. Herzschrittmacherther Elektrophysiol. 2023 Mar;34(1):59-65. German. doi: 10.1007/s00399-022-00915-2. Epub 2022 Dec 29. PMID: 36580092; PMCID: PMC9798365.
22.Agewall S. Atrial fibrillation has gone from a boring disease to a very hot condition. Why is that? Eur Heart J Cardiovasc Pharmacother. 2023 Jul 29;9(5):401-402. doi: 10.1093/ehjcvp/pvad049. PMID: 37486237.
23.Kantharia BK, Zhao S, Linz D, Heijman J, Wehrens XHT. Hypertension and Atrial Fibrillation: Insight From Basic to Translational Science Into the Mechanisms and Management. J Cardiovasc Electrophysiol. 2025 Oct;36(10):2712-2719. doi: 10.1111/jce.16632. Epub 2025 Mar 6. PMID: 40051126.
24.Zou F, Krumerman A. Atrial Tachycardia Masquerading as Atrial Fibrillation Following Bi-Atrial MAZE Procedure. Card Electrophysiol Clin. 2024 Jun;16(2):169-174. doi: 10.1016/j.ccep.2023.10.004. Epub 2023 Nov 7. PMID: 38749637.
25.Dixit S, Oranefo JU, Raad M. Atrial Fibrillation Management With Antiarrhythmic Drug Therapy: Balancing Benefits and Bradycardia Risks. J Am Coll Cardiol. 2024 Mar 19;83(11):1039-1041. doi: 10.1016/j.jacc.2024.01.015. PMID: 38479952.
Published
2026/04/24
Issue
Ahead of print
Section
Original paper

Copyright (c) 2026 Anqi Guo, Jiayi Zhu, Liqun Zhao

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