title: 1H NMR-derived metabolomics of filtered serum of myocardial ischemia in unstable angina patients.
abstract: BACKGROUND
  Despite continuing research for development of accurate biomarkers of myocardial ischemia in unstable angina, lack of biochemical biomarkers is alarming. We sought to develop accurate biomarkers using high throughput proton nuclear magnetic resonance ((1)H NMR) spectroscopy and filtered serum (lacking proteins and lipoproteins) based metabolomics for detecting myocardial ischemia in unstable angina patients with utmost precision.
  
  
  METHODS
  Study includes 127 filtered serum samples from myocardial ischemia in unstable angina patients (UA; n=65) and healthy controls (HC; n=62). High resolution NMR spectra were obtained to highlight metabolic perturbations of small metabolites. A supervised orthogonal partial least square discriminant analysis was applied to generate a prediction model. Receiver operating characteristic (ROC) curve analysis was performed to reveal the clinical utility of signature biomarkers.
  
  
  RESULTS
  Five biomarkers--valine, alanine, glutamine, inosine and adenine--could differentiate 95% of UA from HC with 96% sensitivity and 95% specificity.
  
  
  CONCLUSIONS
  (1)H NMR-based filtered serum metabolic profiling appears to be an assuring, least invasive and faster way to screen and identify myocardial ischemia in unstable angina patients.
authors.affiliation: Department of Biochemistry, King George's Medical University, Lucknow, India.
authors.forename: Keerti
authors.initials: K
authors.lastname: Ameta
authors.affiliation: Centre of Biomedical Research, SGPGIMS Campus, Lucknow, India. Electronic address: ashishg24@yahoo.co.in.
authors.forename: Ashish
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Cardiology, King George's Medical University, Lucknow, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Ameta
authors.affiliation: Department of Cardiology, King George's Medical University, Lucknow, India.
authors.forename: Rishi
authors.initials: R
authors.lastname: Sethi
authors.affiliation: Centre of Biomedical Research, SGPGIMS Campus, Lucknow, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Department of Biochemistry, King George's Medical University, Lucknow, India.
authors.forename: Israr
authors.initials: I
authors.lastname: Ahmad
authors.affiliation: Department of Biochemistry, King George's Medical University, Lucknow, India. Electronic address: abbasalimahdi@gmail.com.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Mahdi
mesh_terms: D000328:Adult; D000789:Angina, Unstable / Q000097:blood* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D055432:Metabolomics / Q000379:methods*; D066244:Proton Magnetic Resonance Spectroscopy
chemical_list: D015415:Biomarkers
keywords: Metabolomics; Myocardial ischemia with unstable angina; NMR spectroscopy