Abstract 10442: Temporal Changes in Plasma Lipidome in Patients with St-Segment Elevation Myocardial Infarction: Impact of Reperfusion

Abstract

Aim: We aim to investigate the temporal changes in plasma lipidome before and after reperfusion in ST-segment elevation myocardial infarction (STEMI) patients and their association with myocardial injury. Methods: Venous blood samples were drawn from STEMI patients (N=80) serially before percutaneous coronary intervention (PCI) and at 2 h, 24 h, 48 h, and 30 days after PCI. Plasma lipid profiling (322 lipids) was performed on STEMI patients and age and gender-matched control subjects (N=50) using an LC/MS platform. Results: Overall, 56.01% of the identified lipid species were significantly altered (corrected p<0.05 ) in the first 24 h following reperfusion in STEMI patients. During early reperfusion, except oxidized phospholipids, the majority of lipid classes/subclasses (14 out of 25) were significantly lower (corrected p<0.05 ) at 2 h post-reperfusion compared to the ischemic state. Of all the lipid classes/subclasses, fatty acids showed the most remarkable change (74.5% lower) in the first 24 h after reperfusion. Multivariable linear regression analyses following adjustment of traditional risk factors identified 33 lipid species that significantly associate (p<0.05) with change in troponin concentration (delta troponin) at different time intervals. Five of these lipid species, namely, acylcarnitine 18:2, TG 51:0, PE (O-38:5), LPC 17:1, and LPC 18:0, could stratify patients in the highest tertile of delta troponin from those in the lowest tertiles. These lipids also were correlated with in-hospital cardiovascular events. Acylcarnitine 18:2, LPC 17:1, and LPC 18:0 as well as their respective whole class amount, were significantly higher (p<0.05) in the STEMI population than the control subjects. Conclusions: Our analyses elucidated a detailed characterization of the temporal alterations in plasma lipidome that occur during human myocardial reperfusion injury.