Prognostic implication of lipidomics in patients with coronary total occlusion undergoing PCI.
Prognostic implication of lipidomics in patients with coronary total occlusion undergoing PCI.
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脂质组学对接受 PCI 的冠状动脉完全闭塞患者的预后意义
DOI：
10.1111/eci.13826
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发表时间：
2022-11
影响因子：
5.5
通讯作者：
中科院分区：
文献类型：
--
作者：
冠状动脉慢性完全闭塞(CTO)患者接受选择性经皮冠状动脉介入治疗(PCI)的预后预测指标仍然缺乏。脂组分析使研究人员能够将脂类与疾病进展联系起来，并可能改善心血管事件的预测。在本研究中，350名个体(50名健康对照、50名冠状动脉疾病患者和250名CTO患者)通过靶向脂组学分析测量了781种血脂。L1正则化Logistic回归用于识别与不良心血管事件相关的脂质种类，并建立预测模型，通过10倍交叉验证(200次重复)进行验证。比较了单独根据临床特征构建的传统模型和结合脂类数据和传统因素构建的组合模型。24种脂类物质仅在CTO患者中表达异常，其中大部分属于鞘磷脂(SM)和三酰甘油(TAG)。与传统危险因素相比，结合血脂和传统因素的新模型在预测冠状动脉介入术后不良心血管事件方面有显著改善(曲线下面积，0.870比0.726，p <； .05；Akaike信息标准，129vs.156；净重分类改进，0.312，p <； .001；综合判别度改进，0.244，p <； .001)。在整合模型的基础上建立了诺模图，并用Kaplan-Meier方法证明了该模型的有效性。脂质组学分析揭示了可能参与CTO形成的脂类物种，并可能有助于CTO患者接受经皮冠状动脉介入治疗的风险分层。
Predictors of prognosis in patients with coronary chronic total occlusion (CTO) undergoing elective percutaneous coronary intervention (PCI) have remained lacking. Lipidomic profiling enables researchers to associate lipid species with disease progression and may improve the prediction of cardiovascular events. In the present study, 781 lipids were measured by targeted lipidomic profiling in 350 individuals (50 healthy controls, 50 patients with coronary artery disease and 250 patients with CTO). L1‐regularized logistic regression was used to identify lipid species associated with adverse cardiovascular events and create predicting models, which were verified by 10‐fold cross‐validation (200 repeats). Comparisons were made between a traditional model constructed with clinical characteristics alone and a combined model built with both lipidomic data and traditional factors. Twenty‐four lipid species were dysregulated exclusively in patients with CTO, most of which belonged to sphingomyelin (SM) and triacylglycerol (TAG). Compared with traditional risk factors, new model combining lipids and traditional factors had significantly improved performance in predicting adverse cardiovascular events in CTO patients after PCI (area under the curve, 0.870 vs. 0.726, p < .05; Akaike information criterion, 129 versus 156; net reclassification improvement, 0.312, p < .001; integrated discrimination improvement, 0.244, p < .001). Nomogram was built based on the incorporated model and proved efficient by Kaplan–Meier method. Lipidomic profiling revealed lipid species which may participate in the formation of CTO and could contribute to the risk stratification in CTO patients undergoing PCI.
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影响因子：
3.4
作者：
Laaksonen, Reijo
通讯作者：
Laaksonen, Reijo
影响因子：
16.2
作者：
Lu, Jieli;Lam, Sin Man;Wang, Weiqing
通讯作者：
Wang, Weiqing
DOI：
10.1038/s41574-021-00572-4
发表时间：
2021-12-01
期刊：
Nature reviews. Endocrinology
影响因子：
--
作者：
Greenhill, Claire
通讯作者：
Greenhill, Claire
影响因子：
6.5
作者：
Anroedh, Sharda;Hilvo, Mika;Kardys, Isabella
通讯作者：
Kardys, Isabella
影响因子：
37.8
作者：
Shah SH;Kraus WE;Newgard CB
通讯作者：
Newgard CB