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Metabolic profiles predict future cardiac events and age is a strong clinical predictor of outcome. Using data from the MURDOCK CV Study we examined the extent to which baseline metabolic profiles vary with age.
We performed targeted mass spectrometry profiling of 69 metabolites and routine lipid analysis on fasting plasma samples from 2002 consecutive patients undergoing cardiac catheterization. Principle components analysis (PCA) was used to create 13 uncorrelated factors. We used linear regression to evaluate relationships between age and PCA factor levels. Factors whose levels varied significantly with age were assessed for association with death and death/MI using Cox proportional hazards regression.
Adjusted levels of 10 of the 13 factors varied significantly with age. For 8, levels increased with older age; for 2, they decreased (Table). Four factors independently predicted death and death/MI: Factor 1 (HRs 1.27 [95% CI, 1.11-1.46]; p=0.0007 and 1.15 [1.01-1.31]; p=0.032 respectively), Factor 2 (HRs 1.21, [1.03-1.41];p=0.018 and 1.17 [1.02-1.35]; p=0.027), Factor 3 (HRs 1.26, [1.09-1.45]; p=0.0016 and 1.20 [1.06-1.36]; p=0.0047), and Factor 12 (HRs 1.15, [1.01-1.30]; p=0.032 and 1.13 [1.01-1.27]; p=0.028). There were no age × factor level interactions.
Baseline metabolic profiles vary with age. However, for factors that were associated with clinical outcomes, the associations were constant across the age continuum.
|Factor 1||Medium-chain acylcarnitines||0.00384||p<0.0001|
|Factor 2||Short-chain dicarboxylacylcarnitines||0.00138||p<0.0001|
|Factor 3||Long-chain dicarboxylacylcarnititines||0.00261||p<0.0001|
|Factor 5||Long-chain acylcarnitines||0.00174||p<0.0001|
|Factor 9||Short-chain acylcarnitines||0.00681||p<0.0001|
|Factor 10||Medium-chain acylcarnitines||0.01453||p<0.0001|
|Factor 12||Fatty acids||0.00716||p=0.0002|
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: New Tests, Targets and Treatments in SIHD
Abstract Category: 10. Chronic CAD/Stable Ischemic Heart Disease: Clinical
Presentation Number: 1240-73
- 2013 American College of Cardiology Foundation