Molecular trash in blood predicts heart disease.

 

Tiny bits of molecular “trash” found in circulating blood appear to be good predictors of cardiovascular disease and untimely death, say researchers at Duke University Medical Center.

The Duke study analyzed metabolites, the molecular debris left over after the body breaks food down into energy sources and building blocks of cells and tissues. Scientists believe metabolites may be useful in diagnosing disease. But the tiny molecules are notoriously hard to identify, quantify and characterize.

Lead researcher, Shah, has been studying metabolic signatures in heart disease for several years and led earlier research showing that metabolic profiles associated with early-onset coronary artery disease can be inherited. Shah wanted to know if they could isolate and identify particular metabolites associated with coronary artery disease.

Researchers selected 174 patients who had experienced early-onset coronary artery disease (CAD) and compared them to 174 controls who had undergone catheterization but who were not found to have CAD. Using a panel of 69 metabolites previously identified as potentially involved in the development of CAD, they examined the metabolic profiles in both groups. 

“We found two sets, or clusters of metabolites that seemed to differentiate between the two groups,” says Shah.

Next, they tested the two sets of metabolites to see if they could differentiate between patients of any age who had CAD and those who did not. Again, the two sets of metabolites were able to discriminate between the two groups.

The researchers found two factors that were clearly associated with coronary artery disease and one factor that predicted greater risk of heart attack or death among patients with coronary artery disease. “When we added these biomarkers to traditional clinical risk models, we found that they increased the accuracy of projected risk,” says Shah.

While earlier studies have suggested that certain metabolites are associated with the presence and severity of CAD, researchers have not been able to identify most of the individual molecules within those profiles, says Shah, “which in the end meant that these studies were not that clinically useful.”  

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

 

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SOURCE

 Duke Medical News
Original abstract: Circulation: Cardiovascular Genetics. 2010
Published online before print February 19, 2010, doi: 10.1161/CIRCGENETICS.109.852814.