Metabolomic characteristics and their value in diagnosis of coronary artery disease

Zhao Juan; Teng Lixin; Mao Mei

doi:10.3969/j.issn.1674-4055.2017.09.26

Abstract：Objective To analyze the diagnostic value of metabolomic changes to different types of coronary artery disease (CAD). Methods The hospitalized patients (n=1086, male 712 and female 374) were chosen from the departments of geriatrics in the Emergency Center of Chongqing City, Tumor Hospital of Chongqing City, Chinese PLA 324 Hospital and the Third People's Hospital of Chongqing City from Jan. 2003 to Jan. 2016. All patients were divided, according to symptoms and examination results, into normal coronary artery group (NCA group, n=116, without coronary stenosis), non-occlusion coronary atherosclerosis group (NOCA group, n=276, coronary stenosis<50%), acute myocardial infarction group (AMI group, n=324), unstable angina group (UA group, n=307) and stable angina group (SA group, n=63). The mass spectra peaks of metabolites in different blood samples were detected by using liquid chromatography-tandem mass spectrometry (LC-MS) for determining all metabolites. Results There were 12 cross comparisons conducted aiming at metabolic disorders of CAD, and 89 different metabolites identified. The changes of metabolic pathways included increase of phospholipid metabolism, decrease of amino acid metabolism, increase of short chain acyl carnitine, decrease of three-carboxylic acid cycle, and decrease of primary bile acid synthesis. The results of receiver operating characteristic curve (ROC) in reviewing diagnostic value of varying metabolites in all groups showed that area under curve (AUC) was 0.952, sensitivity was 94.2% and specificity was 80.7% in NOCA group and NCA group (n=392), 0.993, 96.4% and 95.6% in SA group and NOCA group (n=339), 0.990, 97.4% and 91.1% in UA group and SA group (n=370), and 0.992, 94.5% and 95.3% in AMI group and UA group (n=631). Conclusion The patients with different types of CAD will suffer from metabolic disorders. The changes of small molecular metabolites have potential value in the antidiastole of CAD.