Improved Risk Prediction of Acute Myocardial Infarction in Patients With Stable Coronary Artery Disease Using an Amino Acid-Assisted Model

IF 3.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Yi-Jing Zhao, Yong Li, Feng-Xiang Wang, Hao Lv, Yaoyao Qu, Lian-Wen Qi, Pingxi Xiao
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引用次数: 0

Abstract

Patients with stable coronary artery disease (CAD) are at an increased risk of acute myocardial infarction (AMI), particularly among older individuals. Developing a reliable model to predict AMI occurrence in these patients holds the potential to expedite early diagnosis and intervention. This study is aimed at establishing a circulating amino acid-assisted model, incorporating amino acid profiles alongside clinical variables, to predict AMI risk. A cohort of 874 CAD patients from two independent centers was analyzed. Plasma amino acid levels were quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS) employing a targeted metabolomics approach. This methodology incorporated 13C isotope-labeled internal standards for precise quantification of 27 amino acids. Univariate logistic regression was applied to identify differentially expressed amino acids that distinguished between stable CAD and AMI patients. To assess prediction performance, receiver operating characteristic (ROC) curve and nomogram analyses were utilized. Five amino acids—lysine, methionine, tryptophan, tyrosine, and N6-trimethyllysine—emerged as potential biomarkers (p < 0.05), exhibiting significant differences in their expression levels across the two centers when comparing stable CAD with AMI patients. For AMI risk prediction, the base model, utilizing 12 clinical variables, achieved areas under the curve (AUC) of 0.7387 in the discovery phase (n = 623) and 0.8205 in the external validation set (n = 251). Notably, the integration of these five amino acids into the prediction model significantly enhanced its performance, increasing the AUC to 0.7651 in the discovery phase (Delong’s test, p = 1.43e-02) and to 0.8958 in the validation set (Delong’s test, p = 8.91e-03). In conclusion, the circulating amino acid-assisted model effectively enhances the prediction of AMI risk among CAD patients, indicating its potential clinical utility in facilitating early detection and intervention.

Abstract Image

利用氨基酸辅助模型改进稳定型冠状动脉疾病患者急性心肌梗死的风险预测
稳定型冠状动脉疾病(CAD)患者发生急性心肌梗死(AMI)的风险增加,尤其是老年人。开发一种可靠的模型来预测这些患者的急性心肌梗死发生率,有可能加快早期诊断和干预。本研究旨在建立一个循环氨基酸辅助模型,将氨基酸谱与临床变量相结合,以预测急性心肌梗死的风险。研究分析了来自两个独立中心的 874 名 CAD 患者。利用液相色谱串联质谱法(LC-MS/MS)和靶向代谢组学方法对血浆氨基酸水平进行了量化。该方法结合了 13C 同位素标记内标,可对 27 种氨基酸进行精确定量。应用单变量逻辑回归来识别区分稳定型 CAD 和 AMI 患者的差异表达氨基酸。为了评估预测性能,采用了接收器操作特征曲线(ROC)和提名图分析。五个氨基酸--赖氨酸、蛋氨酸、色氨酸、酪氨酸和 N6-三甲基赖氨酸--成为潜在的生物标记物(p <0.05),在将稳定型 CAD 与 AMI 患者进行比较时,这五个氨基酸的表达水平在两个中心之间存在显著差异。在急性心肌梗死风险预测方面,利用 12 个临床变量的基础模型在发现阶段(n = 623)的曲线下面积(AUC)为 0.7387,在外部验证集(n = 251)中的曲线下面积(AUC)为 0.8205。值得注意的是,将这五种氨基酸整合到预测模型中可显著提高其性能,在发现阶段将 AUC 提高到 0.7651(德龙检验,p = 1.43e-02),在验证集中提高到 0.8958(德龙检验,p = 8.91e-03)。总之,循环氨基酸辅助模型有效地提高了对 CAD 患者 AMI 风险的预测,表明其在促进早期发现和干预方面具有潜在的临床实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardiovascular Therapeutics
Cardiovascular Therapeutics 医学-心血管系统
CiteScore
5.60
自引率
0.00%
发文量
55
审稿时长
6 months
期刊介绍: Cardiovascular Therapeutics (formerly Cardiovascular Drug Reviews) is a peer-reviewed, Open Access journal that publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of new cardiovascular therapies. Articles on translational research, pharmacogenomics and personalized medicine, device, gene and cell therapies, and pharmacoepidemiology are also encouraged. Subject areas include (but are by no means limited to): Acute coronary syndrome Arrhythmias Atherosclerosis Basic cardiac electrophysiology Cardiac catheterization Cardiac remodeling Coagulation and thrombosis Diabetic cardiovascular disease Heart failure (systolic HF, HFrEF, diastolic HF, HFpEF) Hyperlipidemia Hypertension Ischemic heart disease Vascular biology Ventricular assist devices Molecular cardio-biology Myocardial regeneration Lipoprotein metabolism Radial artery access Percutaneous coronary intervention Transcatheter aortic and mitral valve replacement.
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