Molecular remains could gauge heart disease--study

Researchers at the Duke University Medical Center examined metabolites--small molecules left after the body tears food into energy and elementary blocks of cells and tissues.

The study attempted to specify metabolic profiles linked to coronary artery disease (CAD), heart attacks and death among patients undergoing coronary catheterization--a minimally invasive procedure to access blood circulation in the heart muscles using a catheter or a tube.

Lead author, Svati Shah, M.D., M.H.S., cardiologist, Duke Heart Center, Duke Center for Human Genetics said, “Metabolites may be useful in diagnosing disease. But the tiny molecules are notoriously hard to identify, quantify and characterize.”

Details of the study
Scientists examined health records and blood samples of 10,000 patients who approached the Center for Nutrition and Metabolism for catheterization, for a period of eight years.

To measure the metabolites, researchers chose 174 patients experiencing the start of coronary artery disease. They were then compared to another group of 174 patients who underwent catheterization but were not diagnosed with CAD.

To study the metabolic profiles in the two groups, researchers used a section of 69 metabolites earlier thought to be linked to the growth of CAD.

After analysis, the team found two factors noticeably related with CAD and one factor predicting an increased risk of heart disease, stroke or death among CAD patients, in contrast to the other group.

“When we added these biomarkers to traditional clinical risk models, we found that they increased the accuracy of projected risk,” said Shah.

Current study compared with previous studies
According to previous studies, distinctive metabolites are responsible for the occurrence and gravity of coronary artery disease. But scientists have been incapable of specifying these molecules.

“This meant that these studies were not that clinically useful,” said Shah.

William Kraus, M.D., professor of medicine at Duke, and senior researcher in the study, said, “Here, we specifically selected clusters of metabolites that we know are involved in multiple pathways of lipid, protein and glucose metabolism--pathways that are often disrupted in CAD--and we showed that they are indeed associated with CAD and subsequent risk of cardiac events.”

“These metabolic profiles may be a way from routine clinical use, but we feel they are a good first step in that direction,” concluded Kraus.

Study appears online in the journal Circulation: Cardiovascular Genetics.