Relationship between metabolites of arachidonic acid and prognosis in patients with acute coronary syndrome

Abstract

Objective: To investigate the correlation of arachidonic acid (ARA) metabolites and prognosis in ACS patients.

Methods and results: This is a mono-center retrospective nested case-control study. We followed up 470 ACS patients, of whom 39 patients had MACE in a mean follow up time of 1037days (identified as MACE group). Another 39 clinically matched patients without MACE were selected from the 470 ACS patients (Non-MACE group). Thirty-nine subjects without Coronary Heart Disease were enrolled as Control group. Metabolites of ARA were determined by LC-MS/MS. We found that plasma levels of LTB4, 8-HETE, 11-HETE, 12-HETE, and 15-HETE were significantly increased in MACE and Non-MACE groups, 5-HETE and 9-HETE were significantly increased in MACE group comparing with Control group (P<0.05). Importantly, plasma level of 19-HETE in MACE group was significantly lower than Non-MACE and Control groups. 19-HETE significantly correlated with the prognosis of ACS after adjustment for clinical characteristics (HR=0.103, 95% C.I.: 0.014-0.766). The AUC for ROC curve of 19-HETE in predicting MACE was 0.637 (P<0.05). Survival analysis showed that ACS patients with 19-HETE levels higher than 0.13ng/ml tend to have better prognosis than those lower than 0.13ng/ml (P<0.05). GRACE score and serum Fib levels were also significantly correlated with MACE. 20-HETE level was found significantly higher in STEMI group comparing with NSTE-ACS group (P<0.05).

Conclusion: Plasma arachidonic acid metabolites may act as prognostic markers for ACS patients.

Keywords: 19-Hydroxyeicosatetraenoic acid (19-HETE); Acute coronary syndrome (ACS); Major adverse cardiovascular event (MACE); Metabolites of arachidonic acid (ARA).