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Metabolomics Study Revealing the Potential Risk and Predictive Value of Fragmented QRS for Acute Myocardial
Jiankang Li1, Wenting Duan2, Lin Wang3
1Institute of Medical Research, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an 710072, Shaanxi, China.
Insights
Nonobstructive coronary artery disease (NOCAD) patients face high acute myocardial infarction (AMI) risks. Metabolomics identified key serum metabolites and fragmented QRS (fQRS) that predict AMI prognosis after percutaneous coronary intervention (PCI).
Area of Science:
- Cardiology
- Metabolomics
- Biochemistry
Background:
- Nonobstructive coronary artery disease (NOCAD) patients exhibit elevated risks for acute myocardial infarction (AMI).
- Fragmented QRS (fQRS) on electrocardiograms shows predictive value for AMI outcomes post-percutaneous coronary intervention (PCI).
Purpose of the Study:
- To identify differential serum metabolites distinguishing NOCAD from AMI patients.
- To elucidate the prognostic value of identified metabolites and fQRS in AMI patients undergoing PCI.
- To clarify the underlying mechanisms linking fQRS to AMI prognosis.
Main Methods:
- A cohort of 254 participants (136 NOCAD, 118 AMI) was analyzed.
- Comprehensive serum metabolomics was performed using UPLC-Q/TOF-MS.
- Multivariate statistical analyses, including OPLS-DA, and hazard ratio calculations were employed.
Main Results:
- Twenty-three differential metabolites were identified between NOCAD and AMI patients.
- Four specific metabolites (acetylglycine, threoninyl-glycine, glutarylglycine, nonanoylcarnitine) differentiated fQRS from non-fQRS in AMI patients.
- Hazard ratios indicated associations between these metabolites and risks of cardiac death, recurrent angina, readmissions, and major adverse cardiovascular events.
Conclusions:
- Novel differential metabolites were identified that distinguish NOCAD from AMI.
- Metabolites and fQRS provide prognostic insights for AMI patients post-PCI, potentially clarifying fQRS's predictive mechanism.
- Findings offer new perspectives on risks and prognosis in AMI, aiding clinical management.
Abstract:
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/TOF-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.
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