Insights into the prognosis of lipidomic dysregulation for death risk in patients with coronary artery disease.
Insights into the prognosis of lipidomic dysregulation for death risk in patients with coronary artery disease.
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冠状动脉疾病患者死亡风险的脂质组学失调预后的见解
DOI：
10.1002/ctm2.189
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发表时间：
2020-09
影响因子：
10.6
通讯作者：
Zhong S
中科院分区：
文献类型：
--
作者：
Qin M;Zhu Q;Lai W;Ma Q;Liu C;Chen X;Zhang Y;Wang Z;Chen H;Yan H;Lei H;Zhang S;Dong X;Wang H;Huang M;Lian Q;Zhong S
血脂异常有助于冠状动脉疾病（CAD）向不良结局的进展。血浆脂质组学测量可改善冠心病临床终点的预后表现。我们的研究旨在确定血浆脂质种类与冠心病患者死亡、主要不良心血管事件（MACE）和左心室重构风险之间的相关性。共纳入1569名中国CAD患者，1011名单中心患者作为内部培训队列，558名多中心患者作为外部验证队列。两个队列的血浆脂质浓度是通过广泛靶向的脂质组学分析确定的。最小绝对收缩、选择算子Cox和多变量Cox回归分别用于建立死亡和MACE的预后模型。10种脂质（Cer（d18:1/20:1）、Cer（d18:1/24:1）、PE（30:2）、PE（32:0）、PE（32:2）、PC（O‐38:2）、PC（O‐36:4）、PC（16:1/22:2）、LPC（18:2/0:0）和LPE(0:0/24:6)）和2种脂质(Cer（d18:1/20:1）和LPC（20:0/0:0）分别与死亡和MACE独立相关。Cer（d18:1/20:1）、Cer（d18:1/24:1）与左室重构相关（P < 0.05）。结合10种脂质和两种传统生物标志物预测5年死亡风险的脂质面板比传统模型具有显著更高的辨识度，曲线下面积从76.56增加到83.65%，连续NRI为0.634，IDI为0.131。此外，该小组成功地用于区分低、中、高风险的多中心患者（P < 0.0001）。进一步分析表明，磷脂酰胆碱双键数和磷脂酰乙醇胺碳原子含量与死亡风险呈负相关。死亡预测的改善证实了血脂作为冠心病患者风险分类预测指标的有效性。长链多不饱和脂肪酸的结构特征与死亡风险之间的关联凸显了对单个脂类在疾病发病机制中的作用进行机制研究的必要性。XXXXX。
Dyslipidaemia contributes to the progression of coronary artery disease (CAD) toward adverse outcomes. Plasma lipidomic measure may improve the prognostic performances of clinical endpoints of CAD. Our research is designed to identify the correlations between plasma lipid species and the risks of death, major adverse cardiovascular event (MACE) and left ventricular (LV) remodeling in patients with CAD. A total of 1569 Chinese patients with CAD, 1011 single‐centre patients as internal training cohort, and 558 multicentre patients as external validation cohort, were enrolled. The concentration of plasma lipids in both cohorts was determined through widely targeted lipidomic profiling. Least absolute shrinkage and selection operator Cox and multivariate Cox regressions were used to develop prognostic models for death and MACE, respectively. Ten (Cer(d18:1/20:1), Cer(d18:1/24:1), PE(30:2), PE(32:0), PE(32:2), PC(O‐38:2), PC(O‐36:4), PC(16:1/22:2), LPC(18:2/0:0) and LPE(0:0/24:6)) and two (Cer(d18:1/20:1) and LPC(20:0/0:0)) lipid species were independently related to death and MACE, respectively. Cer(d18:1/20:1) and Cer(d18:1/24:1) were correlated with LV remodeling (P < .05). The lipidic panel incorporating 10 lipid species and two traditional biomarkers for predicting 5‐year death risk represented a remarkable higher discrimination than traditional model with increased area under the curve from 76.56 to 83.65%, continuous NRI of 0.634 and IDI of 0.131. Furthermore, the panel was successfully used in differentiating multicentre patients with low, middle, or high risks (P < .0001). Further analysis indicated that the number of double bonds of phosphatidyl choline and the content of carbon atoms of phosphatidyl ethanolamines were negatively associated with death risk. Improvement in the prediction of death confirms the effectiveness of plasma lipids as predictors to risk classification in patients with CAD. The association between the structural characteristics of long‐chain polyunsaturated fatty acids and death risk highlights the need for mechanistic research that characterizes the role of individual lipid species in disease pathogenesis. XXXXX.
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影响因子：
--
作者：
Li W;Yang X;Xing S;Bian F;Yao W;Bai X;Zheng T;Wu G;Jin S
通讯作者：
Jin S
影响因子：
3.3
作者：
Birner, R;Bürgermeister, M;Daum, G
通讯作者：
Daum, G
影响因子：
6.5
作者：
Anroedh, Sharda;Hilvo, Mika;Kardys, Isabella
通讯作者：
Kardys, Isabella
影响因子：
6.5
作者：
Glaros, Elias N.;Kim, Woojin S.;Garner, Brett
通讯作者：
Garner, Brett
影响因子：
5.8
作者：
Glaros, Elias N.;Kim, Woojin S.;Garner, Brett
通讯作者：
Garner, Brett