Abstract

As an emerging platform technology, metabolomics offers new insights into the pathomechanisms associated with complex disease conditions, including cardiovascular diseases. It also facilitates assessing the risk of developing the disease before its clinical manifestation. For this reason, metabolomics is of growing interest for understanding the pathogenesis of acute coronary syndromes (ACS), finding new biomarkers of ACS, and its associated risk management. Metabolomics-based studies in ACS have already demonstrated immense potential for biomarker discovery and mechanistic insights by identifying metabolomic signatures (e.g., branched-chain amino acids, acylcarnitines, lysophosphatidylcholines) associated with disease progression. Herein, we discuss the various metabolomics approaches and the challenges involved in metabolic profiling, focusing on ACS. Special attention has been paid to the clinical studies of metabolomics and lipidomics in ACS, with an emphasis on ischemia/reperfusion injury.

Highlights

  • IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations

  • Our study showed that lipids and their derivatives formed the bulk of the altered metabolome in the setting of reperfusion injury in segment elevation myocardial infarction (STEMI)

  • We identified a panel of three lipid molecules, namely pentadecanoic acid, 18:2 carnitine, and 18:2 lysophosphatidylcholine, that can determine the extent of I/R

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Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The usual cause of acute occlusion is coronary artery thrombosis caused by rupture or erosion of a high-risk, lipid-laden, atheromatous plaque [5] This sudden, reduced blood flow to the heart results in an imbalance between myocardial metabolic demands and blood supply, leading to myocardial ischemia, which is the hallmark of ACS [3,6]. Metabolomics is the new entrant in the ‘omics’ cascade in the systems biology (genomics, transcriptomics, and proteomics) approach (Figure 2) It involves high-throughput identification and quantification of small chemical compounds (

Analytical Tools in Metabolomics
NMR Spectroscopy
Main Findings
Mass Spectrometry
Pre-Analytical Considerations in Metabolomics Studies
Extraction Procedures for Metabolomics
Data Processing in Metabolomics
Handling Unwanted Variances in Metabolomics Data
Metabolomics in ACS
Lipidomics in ACS
Translational Metabolomics and Future Directions
10. Conclusions
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