title: Plasma lipidomic analysis of stable and unstable coronary artery disease.
abstract: OBJECTIVE
  Traditional risk factors for coronary artery disease (CAD) fail to adequately distinguish patients who have atherosclerotic plaques susceptible to instability from those who have more benign forms. Using plasma lipid profiling, this study aimed to provide insight into disease pathogenesis and evaluate the potential of lipid profiles to assess risk of future plaque instability.
  
  
  RESULTS
  Plasma lipid profiles containing 305 lipids were measured on 220 individuals (matched healthy controls, n=80; stable angina, n=60; unstable coronary syndrome, n=80) using electrospray-ionisation tandem mass spectrometry. ReliefF feature selection coupled with an L2-regularized logistic regression based classifier was used to create multivariate classification models which were verified via 3-fold cross-validation (1000 repeats). Models incorporating both lipids and traditional risk factors provided improved classification of unstable CAD from stable CAD (C-statistic=0.875, 95% CI 0.874-0.877) compared with models containing only traditional risk factors (C-statistic=0.796, 95% CI 0.795-0.798). Many of the lipids identified as discriminatory for unstable CAD displayed an association with disease acuity (severity), suggesting that they are antecedents to the onset of acute coronary syndrome.
  
  
  CONCLUSIONS
  Plasma lipid profiling may contribute to a new approach to risk stratification for unstable CAD.
authors: Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. peter.meikle@bakeridi.edu.au
authors: Peter J
authors: PJ
authors: Meikle
authors: Gerard
authors: G
authors: Wong
authors: Despina
authors: D
authors: Tsorotes
authors: Christopher K
authors: CK
authors: Barlow
authors: Jacquelyn M
authors: JM
authors: Weir
authors: Michael J
authors: MJ
authors: Christopher
authors: Gemma L
authors: GL
authors: MacIntosh
authors: Benjamin
authors: B
authors: Goudey
authors: Linda
authors: L
authors: Stern
authors: Adam
authors: A
authors: Kowalczyk
authors: Izhak
authors: I
authors: Haviv
authors: Anthony J
authors: AJ
authors: White
authors: Anthony M
authors: AM
authors: Dart
authors: Stephen J
authors: SJ
authors: Duffy
authors: Garry L
authors: GL
authors: Jennings
authors: Bronwyn A
authors: BA
authors: Kingwell
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D000789:Angina, Unstable / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008055:Lipids