ASSESSING THE UTILITY OF CIRCULATING CELL-FREE DNA AS A BIOMARKER FOR CORONARY HEART DISEASE IN ATHLETES

Abstract

Background: Circulating cell-free DNA (cfDNA) is emerging as a promising non-invasive biomarker for various conditions, including prenatal care, autoimmune diseases, and cancer. However, its application in diagnosing coronary heart disease (CHD) among athletes remains underexplored. Methods: This study analyzed plasma cfDNA levels in athletes diagnosed with CHD, presenting with myocardial infarction (MI) or heart failure (HF), compared to healthy athletic controls. Plasma levels of traditional cardiac markers such as creatine kinase (CK), creatine kinase MB (CK-MB), aspartate aminotransferase (AST), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also measured to evaluate their correlation with cfDNA levels. The detection was performed using SYBR GREEN assay. Results: CfDNA levels were significantly elevated in athletes with CHD, both with and without MI, compared to controls (p<0.001). Furthermore, cfDNA concentrations were higher in cases of MI compared to CHD without MI (p<0.001), and while elevated in HF, they were less than those found in broader CHD cases (p<0.001). CfDNA showed a significant linear association with AST in CHD cases (p=0.016) but not with CK, CK-MB, or NT-proBNP. Notably, a positive association was found between cfDNA and NT-proBNP specifically in MI cases. ROC curve analysis indicated that cfDNA could potentially serve as a more effective biomarker for CHD diagnosis in athletes than traditional cardiac markers. Conclusions: The detection of cfDNA offers a highly accurate and reproducible method that could significantly enhance the diagnosis and monitoring of coronary heart disease in athletes. This method holds promise for improving early detection and management strategies, crucial for maintaining the health and performance levels of athletes at risk or suffering from CHD.