Abstract
BackgroundN-acetylneuraminic acid (Neu5Ac) is a functional metabolite involved in coronary artery disease (CAD). We aimed to evaluate the relationship between serum Neu5Ac and the risk and prognosis of acute coronary syndrome (ACS) in a real-world prospective study.MethodsPatients with suspected ACS who underwent coronary angiography were included. Serum Neu5Ac was measured at admission. Coronary lesion severity was evaluated by Gensini Score. GRACE risk stratification was performed at admission. Major adverse cardiac events (MACEs) were recorded during follow-up.ResultsA total of 766 patients, including 537 with unstable angina (UAP), 100 with myocardial infarction (MI), and 129 without CAD were included. The circulating Neu5Ac level was significantly higher in patients with MI (median [1QR]: 297[220, 374] ng/ml) than in those with UAP (227 [114, 312] ng/ml) or without CAD (207 [114, 276] ng/ml; both p < 0.001). Serum level of Neu5Ac was positively correlated with age, hypertension, serum uric acid, creatinine, MB isoform of creatine kinase (CK-MB), and Gensini score (all p < 0.05). Receiver operating characteristic curve analysis showed that a higher serum Neu5Ac was potentially associated with MI and high-risk GRACE stratification in ACS patients. Logistic analysis identified only elevated serum Neu5Ac as an independent predictor of MACEs in these patients (odds ratio [OR]: 1.003, 95% confidence interval [CI]: 1.002–1.005, p < 0.001).ConclusionsSerum Neu5Ac is associated with myocardial injury, GRACE risk category, and prognosis in ACS patients.
Highlights
N-acetylneuraminic acid (Neu5Ac) is a functional metabolite involved in coronary artery disease (CAD)
Patient inclusion criteria Consecutive patient were included according to the following criteria: (1) patients had suspected acute coronary syndrome (ACS) and received coronary angiography (CAG) within the study periods; and (2) data regarding baseline demographic factors, comorbidities, concurrent medications, CAG results, and biochemical parameters could be obtained, including age, gender, current smoking status, prevalence of hypertension, diabetes mellitus (DM), histories of atrial fibrillation (AF) and previous stroke, and total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), uric acid (UA), serum creatinine (SCr), lipoprotein (a) (Lp(a)); and (3) the serum level of Neu5Ac on admission was available
According to the clinical manifestations, ECG features, serum troponin, and CAG findings, these patients were classified as UAP patients (n = 100, NSTEMI: 21, segment elevation myocardial infarction (STEMI): 79), myocardial infarction (MI) patients (n = 100) or non-CAD controls (n = 129)
Summary
N-acetylneuraminic acid (Neu5Ac) is a functional metabolite involved in coronary artery disease (CAD). We aimed to evaluate the relationship between serum Neu5Ac and the risk and prognosis of acute coronary syndrome (ACS) in a real-world prospective study. Studies of the key molecular pathways involved in the pathogenesis and progression of ACS are still of fundamental clinical importance for improving risk stratification and targeted treatment in these patients [9]. The changes in serum Neu5Ac in patients with various subtypes of ACS, the association between serum Neu5Ac and coronary lesion characteristics, risk stratification, and the relationship between serum Neu5Ac and prognosis of ACS, to the best of our knowledge, have not been fully explored. The aim our study was to investigate the role of serum Neu5Ac in a real-world ACS patient cohort
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