Abstract 15746: Novel Metabolic Biomarkers Predict Cardiovascular Mortality
Background: Cardiovascular disease (CVD) is the Leading cause of mortality worldwide. Traditional risk factors of CVD have modest predictive power and discrimination. New biomarkers for CVD prediction are urgently required.
Hypothesis: We used 1H NMR metabonomic profiling of serum to identify novel biomarkers of CVD.
METHODS: We investigated 9,179 men and women, recruited between 2002-2008, participating in the London Life Sciences Population (LOLIPOP) study. Participants were followed up for CVD mortality to July 2011 (mean 5.5 years per person) and were assessed for CVD risk factors, including smoking, body mass index, blood pressure, fasting glucose and lipid profile. 1H NMR metabonomic profiling was done on baseline serum sample by 12T Bruker spectrometer, with quantification of 44 fatty acid and low molecular weight markers.
RESULTS: There were 161 CVD deaths. Traditional risk factors were higher in people with CVD death compared to survivors (Table, all P<0.001). Framingham risk scores were higher in cases with CVD death than survivors (18.7±0.9% vs 11.4±0.7%, P=10-31). We identified six NMR metabolites associated with incident CVD; odds ratios (95%CI) for CVD per 1SD increase in biomarker ranged from 1.19 (1.07-1.33, P=0.007) to 1.65 (1.44-1.89, P=3x10-13). The associations of NMR metabolites with CVD were not altered by adjustment for age, gender and Framingham risk score. The AUC for prediction of incident CVD was 0.74 using Framingham risk score alone, and 0.77 with incorporation of metabonomic measures.
Conclusions: We identified six novel biomarkers for incident CVD; independent of known CVD risk factors and may improve CVD risk prediction. Our findings demonstrate the potential utility of metabonomic profiling for biomarker discovery and risk stratification particularly in CVD.
Table legend. Baseline characteristics of the 161 people with CVD death and the 9,018 survivors, participating in the LOLIPOP study. Results provided as mean (SD) or %.
- © 2013 by American Heart Association, Inc.