Peripheral Levels of the Brain-Derived Neurotrophic Factor in Coronary Artery Disease: A Systematic Review and Meta-Analysis

Parnian Shobeiri; Amir Hossein Behnoush; Amirmohammad Khalaji; Antonio Lucio Teixeira; Nima Rezaei

doi:10.18502/jthc.v18i4.14823

Parnian Shobeiri Children’s Medical Center Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Amir Hossein Behnoush Children’s Medical Center Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Amirmohammad Khalaji Children’s Medical Center Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Antonio Lucio Teixeira Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, TX, United States.
Nima Rezaei Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v18i4.14823

Keywords: Brain-derived neurotrophic factor; Coronary disease; Systematic review; Meta-analysis

Abstract

Background: Among its functions, brain-derived neurotrophic factor (BDNF) regulates endothelial and macrophage activation, possibly playing a role in atherosclerotic plaque pathophysiology. Given contradicting reports, this study sought to investigate whether blood levels of BDNF differed between patients with coronary heart disease (CHD) and controls.

Methods: We explored PubMed, Embase, Web of Science, and Cochrane Library for studies comparing BDNF blood levels in patients with CHD and controls. Random-effect meta-analysis was conducted to calculate the standardized mean differences (SMD) and 95% confidence intervals (CI). The Newcastle-Ottawa scale was used to evaluate the quality of included articles, and statistical analyses were conducted using R version 4.0.4.

Results: The final analysis comprised 12 investigations covering 1422 CHD cases and 929 controls with mean ages of 59.66±13.56 and 53.78±13.61 years, respectively. The initial analyses revealed a tendency toward low levels of BDNF in the CHD group compared with the control group (SMD= -0.41; 95% CI, -1.12 to 0.30; P=0.26). After the removal of outliers, the difference achieved statistical difference (SMD= -0.56; 95% CI, -0.93 to -0.19; P<0.01). Subgroup analysis demonstrated no significant difference between serum and plasma BDNF levels (P=0.54); however, subgroup analyses of studies investigating plasma BDNF showed that patients with CHD had significantly lower BDNF levels.

Conclusion: Serum and plasma BDNF concentrations were considerably lower in patients with CHD than in healthy controls. Further studies of higher quality are required on the potential role of BDNF as a biomarker of CHD pathophysiology and severity.