Predicting heart attack risk using novel metabolite biomarkers

The analysis of genome-wide association studies has identified specific plasma metabolites that indicate the risk of heart attack, enabling timely detection, early intervention and tailored treatment strategies.

Researchers from Chinese PLA General Hospital (Beijing, China), Jiangbin Hospital (Guangxi, China) and Minzu Hospital (Guangxi, China) identified 13 novel metabolite biomarkers in plasma that are associated with myocardial infarction (MI) risk. Their findings were published in the Journal of Geriatric Cardiology.

“Global progress against cardiovascular disease is flatlining. Though rates of cardiovascular disease deaths globally have fallen in the last 3 decades, this trend has begun to stall and, without concerted efforts, is at risk of reversing,” urged the World Heart Federation in their 2023 World Heart Report.

MI is a dangerous cardiovascular event caused by lowered or complete cessation of blood flow to a portion of the myocardium. MIs can be ‘silent’ and undetected with little to no symptoms, or life-threatening with a risk of sudden death. Surviving an MI is largely dependent on timely identification, symptom recognition and prompt therapeutic intervention. Plasma metabolite biomarkers are an attractive research avenue in timely MI identification due to their important role in the physiological pathways involved in MIs.

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To understand the role plasma metabolites play in MI, researchers analyzed data sets from large-scale genome-wide association studies, including information from over 460,000 individuals of European descent. To analyze such a large amount of data, they employed a bidirectional Mendelian randomization approach that can narrow down millions of possibilities.

“Bidirectional Mendelian randomization studies represent a robust methodological approach, with numerous advantages not commonly present in traditional research methodologies. These include mitigating the impact of confounding factors on conclusions and exploring reverse causation, thereby providing a more reliable foundation for casual inferences”, explained Qiang Wu from the Senior Department of Cardiology at Chinese PLA General Hospital.

The analysis reported 198 unique plasma metabolites that were identified to have a significant association with MI. 14 plasma metabolites showed a direct relationship with MI risk: eight metabolites were linked to a decreased risk and six metabolites were linked to an increased risk. Among these 14 metabolites, 13 plasma metabolite biomarkers had never been identified previously. These novel biomarkers will offer new options for developing diagnostic tests, routine screenings and treatments for heart attacks.

Looking forward, the group is going to explore the mechanisms of these plasma metabolites and how they are related to MI. It is hypothesized that the eight plasma metabolites that were associated with a decreased risk of MI could possess anti-inflammatory properties and reduce oxidative stress in the body. Further research is needed to confirm this hypothesis.

“Timely detection using metabolic signatures could usher in a new era of preventive cardiology, where interventions are tailored to an individual’s metabolic profile. Furthermore, understanding the metabolic underpinnings of MI will contribute to the development of point-of-care diagnostic tools, providing rapid and accessible assessments. Thus, the findings of the study can revolutionize clinical practice by enabling early and precise diagnoses, ultimately causing more effective and tailored treatment strategies,” commented Qiang Su from the Department of Cardiology at Jiangbin Hospital.