Predictive value of serum resolvin D1, absent in melanoma 2 and interleukin-1β levels for the presence and severity of coronary artery disease in chronic coronary syndrome
D Ozturk Efe, A Akyuz, H Orta, A Demirkiran, C Aydin, S Alpsoy, C Fidan, A CelikkolAbstract
Background
Atherosclerosis plays a central role in coronary artery disease(CAD). Inflammasome activation, particularly via AIM2, promotes IL-1β release and vascular inflammation, driving plaque progression. AIM2 contributes to IL-1β production and upregulated in CAD. In contrast, Resolvin D1(RvD1), a specialized pro-resolving lipid mediator, supports inflammation resolution and plaque stability. However, the interplay between inflammasome-related inflammation and pro-resolving pathways in CCS remains insufficiently defined.
Purpose
The aim of this study is to investigate serum, RvD1, AIM2, and IL-1β levels in CCS patients and to reveal the relationship between these biomarkers with the presence and severity of coronary artery disease(CAD).
Methods
In this prospective observational study between September 2024 and November 2025, patients suspected of having CCS based on clinical findings and non-invasive imaging methods were sequentially enrolled.141 patients meeting the inclusion criteria were enrolled in the study.Coronary angiography images were evaluated by experienced cardiologists, and the severity of CAD was assessed using the SYNTAX score. Serum levels of biomarkers were measured using an enzyme-linked immunosorbent assay (ELISA).
Results
Total of 141 patients with a mean age of 59.5±9.4 years and 68.8% male were included in the study.Patients were divided into three groups according to their SYNTAX score:SYNTAX=0 (n=42), SYNTAX 1–22(n=46), and SYNTAX>22(n=53). Statistically significant differences were found between the groups in terms of age, gender, urea, creatinine, uric acid, HDL levels, also RvD1 levels were higher in the SYNTAX=0 group and decreased with increasing disease severity (813.6[793–846.8]; 724.4 [703.6–747.9]; 723.4[703.2–743.9],p<0.001 respectively). In contrast, AIM2(1.5[1.3–1.7];1.7[1.5–2.2]; 1.9[1.7–2.2],p<0.001 respectively) and IL-1β levels (748[627.6–887.8]; 895.5[730.3–1177.1]; 891.7[723.4–1020.6],p=0.031respectively) increased as disease severity increased. In multivariate analysis, age(β=0.197,p=0.005,), gender(β=0.552,p=0.001) and RvD1 (β=0.512,p<0.001) were identified as independent predictors of SYNTAX score. In correlation analysis, a strong negative correlation (r=−0.603, p<0.001) was found between the SYNTAX score and RvD1, positive correlation between the SYNTAX score and AIM2(r=0.312, p<0.001), In the ROC analysis for predicting the SYNTAX=0 or SYNTAX>0 RvD1 was found to have high discriminatory power AUC=0.945, while AUC=0.704 was calculated for AIM2. For RvD1 a cut-off value of <766.6ng/L predicted the presence of CAD with 93.9% sensitivity and 90.4% specificity.
Conclusions
Our study demonstrated a significant association between serum RvD1 levels and the SYNTAX score, and showed that serum RvD1 levels predicted the severity and presence of angiographic stenosis(>50%) with high discriminatory power in patients evaluated for CCS.figure 1:tablesfigure 2