P775Acute coronary syndromes: mechanistic insights and risk prediction through lipoprotein lipidomics

作者：Bronwyn A. Kingwell, Melissa F. Formosa, Natalie A. Mellett, Kaushala S. Jayawardana, Corey Giles, David A. Bertovic, Garry Jennings, W. Childs, Medini Reddy, Arul Baradi, Shane Nanayakkara, Ana Maria Miranda Martins Wilson, Stephen James Duffy, Peter J. Meikle · 发表于：European Heart Journal · 年份：2018 · DOI：10.1093/eurheartj/ehy564.p775 · 研究领域：Lipoproteins and Cardiovascular Health、Cancer, Lipids, and Metabolism

Background: Although acute coronary syndromes (ACS) are a major cause of morbidity and mortality worldwide, there remains limited understanding of the precipitating mechanisms, and it is still not possible to accurately identify those who are most vulnerable. Purpose: We hypothesized that lipidomic profiles of lipoprotein sub-fractions would provide insight into mechanisms of plaque erosion and rupture and better predict future ACS than whole plasma lipidomic profiles. Methods: One-hundred and thirty individuals with de novo presentation of an ACS (ST-elevation myocardial infarction (STEMI) and non-STEMI) or stable coronary artery disease (CAD) were recruited. Venous blood samples were collected prior to coronary catheterisation and apolipoprotein A (apoA) and apoB subfractions derived by precipitation. For each study participant, an an expanded lipidomic analysis than previously reported was performed on whole plasma as well as both fractions using liquid chromatography electrospray ionization–tandem mass spectrometry. Adjusted logistic regression models with Benjamini-Hochberg correction for false discovery were used to determine the association of each lipid class, subclass and species with ACS both in whole plasma as well as the apoA and apoB subfractions. Multivariate models with optimism correction were developed using risk factors alone, lipids alone or a combination of lipids and risk factors and evaluated using C-statistic and percent accuracy to discriminate ACS fro...