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Plasma lipidome differences in patients with and without significant carotid plaque
Martin Malý1, Ondřej Kučerka2, Kamila Bechyňská3
1Department of Medicine, First Faculty of Medicine, Charles University in Prague and the Military University Hospital, Prague 16902, Czech Republic.
Insights
Plasma lipidomics can identify vulnerable atherosclerotic plaques. Distinct lipid profiles, particularly decreased lysophosphoethanolamines and triacylglycerols, help predict plaque instability and stroke risk.
Area of Science:
- Biochemistry
- Cardiovascular Medicine
- Analytical Chemistry
Background:
- Atherosclerosis in carotid arteries is a primary cause of ischemic stroke.
- Early detection of advanced atherosclerosis and plaque vulnerability is crucial for preventing adverse events.
- Plaque size alone does not accurately predict the risk of stroke.
Purpose of the Study:
- To investigate plasma lipidomics as a diagnostic tool for stratifying carotid plaque stability.
- To determine if lipid profiles can differentiate between stable and unstable plaques without invasive procedures.
Main Methods:
- Utilized liquid chromatography-high-resolution tandem mass spectrometry (LC-MS/MS) for plasma lipidomics.
- Characterized and compared lipid profiles in patients with stable versus vulnerable atherosclerotic plaques.
- Developed a statistical model for patient stratification based on lipid profiles.
Main Results:
- Significant differences in plasma lipid profiles were observed between patients with stable and unstable carotid plaques.
- Lysophosphoethanolamines, fatty acyl esters of hydroxy fatty acids, free fatty acids, plasmalogens, and triacylglycerols were key predictors of plaque vulnerability.
- Most predictive lipid compounds were decreased in plasma of patients with unstable plaques.
Conclusions:
- Plasma lipidomes differ between patients with stable and unstable carotid plaques.
- Specific lipid compounds show potential as biomarkers for identifying unstable plaques.
- LC-MS/MS-based lipidomics may offer a non-invasive method for clinical diagnosis of plaque vulnerability.
Background:
Atherosclerosis is a major cause of ischemic stroke, and early detection of advanced atherosclerosis in the carotid artery is important for reducing morbidity and mortality. What is even more important is not only detection of atherosclerosis but early determination whether the patients are at high risk of an event with adverse effects as the size of the plaque does not necessarily reflect its potential to trigger such events.
Aim:
We studied whether plasma lipidomics profile can be used as a diagnostic tool for stratification of stable or unstable plaques without the need of removing the carotid plaque.
Methods:
This study used liquid chromatography high-resolution tandem mass spectrometry lipidomics to characterize lipid profiles in patients' plasma and found that patients with significant and complicated (vulnerable) atherosclerotic plaque had distinct lipid profiles compared to those with insignificant plaques.
Results:
The lipid classes that were most predictive of vulnerable plaque were lysophosphoethanolamines, fatty acyl esters of hydroxy fatty acids, free fatty acids, plasmalogens, and triacylglycerols. Most of these compounds were found decreased in plasma of patients with unstable plaques which enabled sufficient performance of a statistical model used for patient stratification.
Conclusions:
Plasma lipidomes measured by liquid chromatography-mass spectrometry show differences in patients with stable and unstable carotid plaques, therefore these compounds could potentially be used as biomarkers for unstable plaque in future clinical diagnosis.
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