Related Experiment Video
Updated: Oct 7, 2025
Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
Published on: November 29, 2024
Innovative Approaches to Assess Intermediate Cardiovascular Risk Subjects: A Review From Clinical to Metabolomics
Aline M A Martins1,2,3, Mariana U B Paiva2, Diego V N Paiva2
1Centre of Metabolomics and Bioanalysis (CEMBIO), San Pablo CEU University, Madrid, Spain.
Insights
Metabolomics screening offers a powerful new approach to improve coronary artery disease (CAD) risk stratification in intermediate-risk individuals. This method enhances non-invasive diagnostics, potentially preventing inadequate preventive therapies for cardiovascular events.
Area of Science:
- Cardiovascular Medicine
- Metabolomics
- Biomarker Discovery
Background:
- Current coronary artery disease (CAD) risk stratification has limited predictive value in asymptomatic, intermediate-risk individuals.
- Atherosclerotic plaques can be silent, leading to sudden cardiac death or acute coronary syndrome as initial manifestations.
- Inaccurate risk assessment can result in suboptimal preventive therapies.
Purpose of the Study:
- To review the role of metabolomics integrated with traditional assessments for improved non-invasive CAD subclinical diagnostics.
- To critically evaluate the findings from mass spectrometry (MS) and nuclear magnetic resonance spectroscopy (NMR) in metabolomics studies.
- To discuss the challenges and potential for clinical implementation of metabolomics in cardiovascular risk stratification.
Main Methods:
- Review of current literature on metabolomics applications in cardiovascular disease.
- Analysis of findings from studies utilizing mass spectrometry (MS) and nuclear magnetic resonance spectroscopy (NMR).
- Discussion of the pathophysiology of atherosclerosis and limitations of traditional risk assessment methods.
Main Results:
- Metabolomics screening, combined with traditional risk factors, shows promise for enhancing non-invasive CAD diagnostics.
- Discriminant metabolites identified through metabolomics can aid in stratifying intermediate-risk patients.
- Analytical platforms like MS and NMR are key to current metabolomics research in this field.
Conclusions:
- Metabolomics represents a powerful approach to improve cardiovascular risk stratification, particularly for intermediate-risk individuals.
- Identified metabolic biomarkers hold potential for clinical translation, aiding in more precise patient management.
- Addressing challenges in data implementation is crucial for integrating metabolomics into clinical practice.
Abstract:
Current risk stratification strategies for coronary artery disease (CAD) have low predictive value in asymptomatic subjects classified as intermediate cardiovascular risk. This is relevant because not all coronary events occur in individuals with traditional multiple risk factors. Most importantly, the first manifestation of the disease may be either sudden cardiac death or acute coronary syndrome, after rupture and thrombosis of an unstable non-obstructive atherosclerotic plaque, which was previously silent. The inaccurate stratification using the current models may ultimately subject the individual to excessive or insufficient preventive therapies. A breakthrough in the comprehension of the molecular mechanisms governing the atherosclerosis pathology has driven many researches toward the necessity for a better risk stratification. In this Review, we discuss how metabolomics screening integrated with traditional risk assessments becomes a powerful approach to improve non-invasive CAD subclinical diagnostics. In addition, this Review highlights the findings of metabolomics studies performed by two relevant analytical platforms in current use-mass spectrometry (MS) hyphenated to separation techniques and nuclear magnetic resonance spectroscopy (NMR) -and evaluates critically the challenges for further clinical implementation of metabolomics data. We also discuss the modern understanding of the pathophysiology of atherosclerosis and the limitations of traditional analytical methods. Our aim is to show how discriminant metabolites originated from metabolomics approaches may become promising candidate molecules to aid intermediate risk patient stratification for cardiovascular events and how these tools could successfully meet the demands to translate cardiovascular metabolic biomarkers into clinical settings.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...