Association of circulating metabolites with risk of coronary heart disease in a European population
Coronary heart disease (CHD) is a complex and heterogenic disease that is increasingly becoming a public health burden worldwide. Current risk assessment is based on classic risk factors (BMI, systolic blood pressure, diabetes, total cholesterol) and two established clinical biomarkers, high-sensitivity C-reactive protein (hsCRP) and high-sensitivity troponin I (hsTnI). An improved risk stratification process would advance preventive actions.
The multinational Biomarker for Cardiovascular Risk Assessment in Europe (BiomarCaRE) consortium aimed to evaluate the association between circulating metabolites and CHD in a large, prospective population-based cohort and to assess the capability of metabolomics for CHD risk stratification. For the present study, baseline serum samples from more than 12,000 individuals with over 2,000 incident CHD events over a median follow-up time of 9.2 years were analyzed.
Of the 141 metabolites quantified, five phosphatidylcholines (PC ae C40:6, PC aa C40:6, PC ae C38:6, PC aa C38:6, PC aa C38:5) showed significant inverse association with the risk of incident CHD after correction for multiple testing: increasing levels of phosphatidylcholines were protective against incident CHD, which is in accordance with previous studies. These circulating metabolites showed a comparable discrimination to classic risk factors and established clinical biomarkers.
These findings not only contribute to a better understanding of the pathophysiology of CHD, but also demonstrate the potential of phosphatidylcholines in the risk assessment of coronary heart disease, underlining the value of metabolomics for biomarker discovery.
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Cavus E, Karakas M, Ojeda FM, Kontto J, Veronesi G, Ferrario MM et al. Association of Circulating Metabolites With Risk of Coronary Heart Disease in a European Population: Results From the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium. (2019) JAMA Cardiol | https://doi.org/10.1001/jamacardio.2019.4130