The Risk of Glycolytic Metabolism Predicting Cardiovascular Events in Patients with Coronary Artery Disease

HUANG Hao; NIE Xiaodong; YIN Yunping

doi:10.12102/j.issn.1672-1349.2025.10.015

Abstract：Objective: To explore the risk of cardiovascular events in patients with coronary heart disease based on glycolytic metabolic levels. Methods: A total of 349 patients (134 in the non-coronary heart disease group and 215 in the coronary heart disease group) who underwent coronary angiography assessment for confirmed or suspected stable coronary heart disease between September 2019 and October 2020 were selected. Patients were followed up for 3 years for cardiovascular events. Plasma concentrations of metabolites in glycolysis, gluconeogenesis, and the tricarboxylic acid cycle were measured using liquid chromatography-mass spectrometry (LC-MS). Results: Compared with the non-coronary heart disease group, the coronary heart disease group had a higher proportion of males, smokers, those using lipid-lowering drugs, and higher triglyceride levels (P < 0.05), while high-density lipoprotein cholesterol (HDL-C) levels were lower (P < 0.05). Metabolite analysis showed that the level of pyruvate was higher in the coronary heart disease group compared to the non-coronary heart disease group (P < 0.05). Compared with the non-coronary heart disease group, the coronary heart disease group had increased proportions of non-fatal myocardial infarction, coronary artery bypass grafting, and percutaneous coronary intervention (P < 0.05). Plasma levels of 3-phosphoglycerate, pyruvate, and lactate were higher in the cardiovascular event group compared to the non-cardiovascular event group, with statistical significance (P < 0.05). For every one standard deviation increase in pyruvate and lactate levels, the risk of cardiovascular events increased (P < 0.001). Conclusion: Elevated levels of pyruvate and lactate are independent biomarkers for predicting the risk of cardiovascular events in patients with coronary heart disease.