title: Unveiling differences between patients with acute coronary syndrome with and without ST elevation through fingerprinting with CE-MS and HILIC-MS targeted analysis.
abstract: Differences in the degree and severity of Acute Coronary Syndrome, associated to differences in the electrocardiogram, together with blood tests of biomarkers classify patients for diagnosis and treatment. Cases where the electrocardiogram and/or biomarkers are not conclusive still appear, and there is a need for complementary biomarkers for routine determinations. Metabolomics approaches with blind fingerprinting could reveal differences in metabolites, which must be confirmed by means of targeted determinations. CE-MS and HILIC-MS are well suited for the determination of highly polar compounds, like those from to the intermediate metabolism, altered due to acute stress induced by myocardial infarction. Serum from patients with ST-elevated and non-ST elevated myocardial infarction was collected at intensive care and emergency units, and fingerprinted with CE-MS. Data pretreatment and analysis showed up carnitine-related compounds and amino acids differentially present in both groups. Acylcarnitines and amino acids were then quantitatively measured with HILIC-MS-QqQ. The significance of the differences and the sensitivity/specificity of each compound were individually evaluated. The ratio of free carnitine to acylcarnitines, together with the ratios of acetylcarnitine to betaine, to threonine, and to citrulline, showed high significance and area under the curve in the respective receiver operating characteristic curves. This study opens new possibilities for defining new sets of biomarkers for refining the diagnosis of the patients with difficult classification.
authors.affiliation: CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain.
authors.forename: Shama
authors.initials: S
authors.lastname: Naz
authors.affiliation: Hospital Universitario de Torrejón, Madrid, Spain.
authors.forename: Ángela Algaba
authors.initials: ÁA
authors.lastname: Calderón
authors.affiliation: CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: García
authors.affiliation: CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain.|Departamento de Química Analítica, Instituto de Química, State University of Campinas, São Paulo, Brazil.
authors.forename: Jessica
authors.initials: J
authors.lastname: Gallafrio
authors.affiliation: Hospital Universitario de Torrejón, Madrid, Spain.
authors.forename: Rodrigo Teijeiro
authors.initials: RT
authors.lastname: Mestre
authors.affiliation: Hospital Universitario de Torrejón, Madrid, Spain.
authors.forename: Elena González
authors.initials: EG
authors.lastname: González
authors.affiliation: Hospital Universitario de Torrejón, Madrid, Spain.
authors.forename: Carlos Muñoz
authors.initials: CM
authors.lastname: de Cabo
authors.affiliation: Hospital Universitario de Torrejón, Madrid, Spain.
authors.forename: Mari Cruz Martín
authors.initials: MCM
authors.lastname: Delgado
authors.affiliation: Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: José Ángel Lorente
authors.initials: JÁL
authors.lastname: Balanza
authors.affiliation: Departamento de Química Analítica, Instituto de Química, State University of Campinas, São Paulo, Brazil.
authors.forename: Ana Valéria Colnaghi
authors.initials: AVC
authors.lastname: Simionato
authors.affiliation: Hospital Universitario de Torrejón, Madrid, Spain.
authors.forename: Nicolás Nin
authors.initials: NN
authors.lastname: Vaeza
authors.affiliation: CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain.
authors.forename: Coral
authors.initials: C
authors.lastname: Barbas
authors.affiliation: CEMBIO, Facultad de Farmacia, Universidad CEU San Pablo, Madrid, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Rupérez
keywords: Acute coronary syndrome; Biomarkers; Carnitine; Fingerprinting; Metabolomics