Abstract
Background: Acute coronary syndrome (ACS) is the main cause of death and morbidity worldwide. The present study aims to investigate the altered metabolites in plasma from patients with ACS and sought to identify metabolic biomarkers for ACS.Methods: The plasma metabolomics profiles of 284 ACS patients and 130 controls were carried out based on an untargeted liquid chromatography coupled with tandem mass spectrometry (LC-MS) approach. Multivariate statistical methods, pathway enrichment analysis, and univariate receiver operating characteristic (ROC) curve analysis were performed.Results: A total of 328 and 194 features were determined in positive and negative electrospray ionization mode in the LC-MS analysis, respectively. Twenty-eight metabolites were found to be differentially expressed, in ACS patients relative to controls (p < 0.05). Pathway analysis revealed that these metabolites are mainly involved in synthesis and degradation of ketone bodies, phenylalanine metabolism, and arginine and proline metabolism. Furthermore, a diagnostic model was constructed based on the metabolites identified and the areas under the curve (AUC) for 5-oxo-D-proline, creatinine, phosphatidylethanolamine lyso 16:0, and LPC (20:4) range from 0.764 to 0.844. The higher AUC value of 0.905 was obtained for the combined detection of phosphatidylethanolamine lyso 16:0 and LPC (20:4).Conclusions: Differential metabolic profiles may be useful for the effective diagnosis of ACS and may provide additional insight into the molecular mechanisms underlying ACS.
Highlights
Despite a variety of available therapeutic options, coronary artery disease (CAD) remains a leading cause of mortality worldwide [1, 2]
Pathway analysis revealed that these metabolites are mainly involved in synthesis and degradation of ketone bodies, phenylalanine metabolism, and arginine and proline metabolism
A diagnostic model was constructed based on the metabolites identified and the areas under the curve (AUC) for 5-oxo-D-proline, creatinine, phosphatidylethanolamine lyso 16:0, and LPC (20:4) range from 0.764 to 0.844
Summary
Despite a variety of available therapeutic options, coronary artery disease (CAD) remains a leading cause of mortality worldwide [1, 2]. Subsequent atherosclerotic plaque rupture or disruption of the overlying endothelial surface is generally associated with obstructive CAD and predominantly leads to a wide range of acute coronary syndromes (ACS) [3,4,5]. Rapid and early detection of ACS is an urgent clinical need, as delays increase the risk of morbidity and mortality. The study of novel biomarkers for the screening and diagnosis of ACS has been the focus of extensive research, but it is still not fully understood. Acute coronary syndrome (ACS) is the main cause of death and morbidity worldwide.
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