Metabolomics Study Revealing the Potential Risk and Predictive Value of Fragmented QRS for Acute Myocardial Infarction
Metabolomics Study Revealing the Potential Risk and Predictive Value of Fragmented QRS for Acute Myocardial Infarction
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DOI：
10.1021/acs.jproteome.0c00247
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发表时间：
2020-08-07
影响因子：
4.4
通讯作者：
Lu, Tingli
中科院分区：
文献类型：
--
作者：
Li, Jiankang;Duan, Wenting;Lu, Tingli
非阻塞性冠状动脉疾病（NOCAD）患者与急性心肌梗死（AMI）相关的风险较高，碎片化QRS （fQRS）对经皮冠状动脉介入治疗（PCI）后AMI的发生具有预测价值。招募了254名参与者，其中来自西安市第一医院的NOCAD患者136名，AMI患者118名。采用UPLC-Q/TOE-MS进行综合代谢组学分析，并进行多变量统计分析。通过测量危险比来区分不同代谢物和fQRS对PCI术后AMI预后的影响。OPLS-DA分离血清中NOCAD和AMI的代谢物。在NOCAD和AMI之间共鉴定出23种差异代谢物。此外，在AMI中，fQRS与非fQRS之间鉴定出4种差异代谢物，即乙酰甘氨酸、苏氨酸甘氨酸、戊二酰甘氨酸和壬酰肉碱。风险比表明，代谢物与心源性死亡、心绞痛复发、再入院和主要心血管不良事件的风险相关，这可能阐明fQRS作为PCI术后AMI预后预测因子的机制。本研究通过鉴定新的差异代谢物，区分NOCAD与AMI之间的差异，阐明fQRS在PCI术后AMI预后中的作用机制，为AMI的潜在风险及预后提供新的认识。
Patients with nonobstructive coronary artery disease (NOCAD) have high risk associated with acute myocardial infarction (AMI), and fragmented QRS (fQRS) has a predictive value of AMI after percutaneous coronary intervention (PCI). A cohort of 254 participants were recruited including 136 NOCAD and 118 AMI patients from Xi'an No. 1 Hospital. Comprehensive metabolomics was performed by UPLC-Q/TOE-MS with multivariate statistical analyses. Hazard ratios were measured to discriminate the prognostic in AMI after PCI between differential metabolites and fQRS. OPLS-DA separated metabolites from NOCAD and AMI in serum. A total of 23 differential metabolites were identified between NOCAD and AMI. In addition, four differential metabolites, namely, acetylglycine, threoninyl-glycine, glutarylglycine, and nonanoylcarnitine, were identified between fQRS and non-fQRS in AMI. The hazard ratios demonstrate that the metabolites were associated with the risk of cardiac death, recurrent angina, readmissions, and major adverse cardiovascular events, which may clarify the mechanism of fQRS as a predictor in the prognostic of AMI after PCI. This study identified novel differential metabolites to distinguish the difference from NOCAD to AMI and clarify the mechanism of fQRS in prognostic of AMI after PCI, which may provide novel insights into potential risks and prognostic of AMI.