Davies, Allan; Wenzl, Florian A; Li, Xinmin S; Winzap, Patric; Obeid, Slayman; Klingenberg, Roland; Mach, François; Räber, Lorenz; Muller, Olivier; Matter, Christian M; Laaksonen, Reijo; Wang, Zeneng; Hazen, Stanley L; Lüscher, Thomas F (2023). Short and medium chain acylcarnitines as markers of outcome in diabetic and non-diabetic subjects with acute coronary syndromes. International journal of cardiology, 389(131261), p. 131261. Elsevier 10.1016/j.ijcard.2023.131261
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BACKGROUND
Carnitine metabolism produces numerous molecular species of short-, medium-, and long-chain acylcarnitines, which play important roles in energy homeostasis and fatty acid transport in the myocardium. Given that disturbances in the carnitine metabolism are linked to cardiometabolic disease, we studied the relationship of circulating acylcarnitines with outcomes in patients with acute coronary syndromes (ACS) and evaluated differences in circulating levels of these metabolites between diabetic and non-diabetic patients.
METHODS
Harnessing a prospective multicentre cohort study (SPUM-ACS; NCT01000701), we measured plasma levels of acylcarnitines, carnitine, and carnitine metabolites to assess their relationship with adjudicated major adverse cardiac events (MACE), defined as composite of myocardial infarction, stroke, clinically indicated revascularization, or death of any cause. The SPUM-ACS study enrolled patients presenting with ACS to Swiss University Hospitals between 2009 and 2012. Acetylcarnitine, octanoylcarnitine, proprionylcarnitine, butyrylcarnitine, pentanoylcarnitine, hexanoylcarnitine, carnitine, γ-butyrobetaine, and trimethylamine N-oxide were measured in plasma using stable isotope dilution high-performance liquid chromatography with online electrospray ionization tandem mass spectrometry.
RESULTS
A total of 1683 patients with ACS were included in the study. All measured metabolites except γ-butyrobetaine and carnitine were higher in diabetic subject (n = 294) than in non-diabetic subjects (n = 1389). On univariate analysis, all metabolites, apart from octenoylcarnitine, were significantly associated with MACE at 1 year. After multivariable adjustment for established risk factors, acetylcarnitine remained an independent predictor of MACE at 1-year (quartile 4 vs. quartile 1, adjusted hazard ratio 2.06; 95% confidence interval 1.12-3.80, P = 0.020).
CONCLUSION
Circulating levels of acetylcarnitine independently predict residual cardiovascular risk in patients with ACS.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Räber, Lorenz |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0167-5273 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
14 Aug 2023 10:26 |
Last Modified: |
08 Sep 2023 00:16 |
Publisher DOI: |
10.1016/j.ijcard.2023.131261 |
PubMed ID: |
37574027 |
Uncontrolled Keywords: |
Acute coronary syndromes Diabetes Microbiome Mortality Risk prediction - major cardiovascular and cerebrovascular events |
BORIS DOI: |
10.48350/185439 |
URI: |
https://boris.unibe.ch/id/eprint/185439 |
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