Study On The Lipidomic Difference Of Coronary Artery Thrombus Load Level In Patients With Acute Myocardial Infarction

ObjectiveCoronary artery thrombus load level has always been an important factor in determining the short-term and long-term prognosis of patients with acute myocardial infarction（AMI）.However,there is still a lack of clinically relevant indicators that can predict the burden of thrombosis in the coronary arteries.Lipids are one of the important factors affecting the stability of coronary atherosclerotic plaques,but the relationship between lipid molecules and the level of thrombotic load in the coronary arteries of patients is still unclear.The purpose of this study is to analyze the lipidomic differences between different levels of thrombus load in the coronary arteries of patients with AMI,in order to screen specific lipid molecules that can predict the thrombotic load in the coronary arteries.Materials and MethodsThis study retrospectively analyzed the clinical case data of 173 patients who were consecutively admitted to the Department of Emergency Medicine,Qianfoshan Hospital,Shandong Province from April 1,2020 to October 1,2020,who were concurrently treated with coronary angiography.All patients were left during coronary angiography.Blood samples from the radial artery and coronary artery were taken.The 42 patients were divided into 4 groups based on clinical manifestations and angiographic results:acute myocardial infarction high thrombotic load group,acute myocardial infarction low thrombotic load group,stable angina pectoris group,and control group.The thrombus load level is divided into 0-5 grades according to the standard.Radial artery and coronary artery blood samples were analyzed by liquid chromatography-mass spectrometry（LC-MS）method.Analyze the heat map and difference distribution map between each group through R language.The lipid ontology enrichment analysis network application（LION/web）is used to collect the specific lipid classification,biophysical data,lipid function and the association between organelles of some important lipid molecules in LIPID MAPS.The statistical analysis was done using IBM SPSS Statistics V25.0 software.Results1.There is no significant statistical difference in general clinical data between each group.2.The relationship between coronary thrombotic load and the differential distribution of lipids.①In the overall trend of coronary artery thrombotic load and differential lipid expression,the experimental results found that with the increase of thrombotic load level,plasma lipids such as PC（40:5）,SM（d42:2）,DG（38:1e）,etc.The content of qualitative components increased significantly,while the content of lipid components such as PE（37:2e）,and TG（16:0₁1:2₁8:1）decreased significantly.②Two of the groups:high thrombotic load group and low thrombotic load group,TG（16:0₁1:4₁6:0）,MePC（30:4）,PC（34:4e）,PE（40:7）and other expressions are up-regulated,While TG（16:0₂0:4₂4:0）,PA（16:0₁8:3）and other expressions are down-regulated.③Compared with the control group,the expressions of TG（15:0₁8:2₂0:5）,DG（34:5e）,TG（16:0₁6:1₁8:3）in the high thrombus load group were up-regulated,and the low thrombus load group TG（15:0₁8:2₂0:5）,DG（34:5e）,TG（16:0₁6:1₁8:3）,etc.upregulated,stable angina group TG（15:0₁8:2₂0:5）,DG（34:5e）,etc.Up.Compared with the control group,PC（16:2e₁8:0）,TG（16:0₁8:1₂2:1）,etc.were down-regulated in the high thrombotic load group,and DG（50:1）,PC（20:2e₁8）in the low thrombotic load group.:1),PC（35:4e）,etc.,stable angina group（PC（16:2e₁8:0）,TG（16:0₁8:1₂2:1）,etc..④Compared with stable angina group,the expression of upregulation is:PC（16:1e₂0:5）,PE（38:5）,HexlCer（d18:1₂0:0）,TG（36:2e）in the acute myocardial infarction high thrombus load group,TG（36:2e）in the acute myocardial infarction low thrombus load group:2e）,PE（38:5）,HexlCer（d18:1₂0:0）,TG（16:0₁1:4₁6:0）,Cer（tl8:0₂4:0）.Down-regulated expressions are:acute myocardial infarction,high thrombosis Load group TG（20:0₁8:1₂2:0）,Cer（d17:0₁8:4）,TG（18:0₁8:1₂0:0）,DG（50:1）,acute myocardial infarction low thrombus load group DG（50:1）,Cer（d17:0₁8:4）,TG（16:0₁1:2₁8:1）,MePC（34:2e）.3.The relationship between radial artery thrombotic load and the differential distribution of lipids.①In the overall trend of radial artery thrombotic load and differential lipid expression,experimental results found that as the level of thrombotic load increased,plasma lipids contained Cer（t18:0₂4:0）,PC（19:1₁9:1）,SM（d18:The content of lipid components such as 1₂4:1）increased significantly,while the content of Cer（d35:4）and PC（29:2）decreased significantly.②Two of the groups:the high thrombotic load group and the low thrombotic load group,AcCa（22:1）,AcCa（22:0）,PC（19:1₁9:1）,CarE（20:0）,PC（42:2）The expressions of SM（t40:3）,SM（d38:3）,DG（50:1）,etc.are up-regulated,while the expressions of SM（t40:3）,SM（d38:3）,and DG（50:1）are down-regulated.③Compared with the control group,the expressions of PC（16:1e₂0:5）,Co（Q8）,PC（35:4e）,Hex2Cer（d42:1）in the high thrombotic load group were up-regulated,and Co（Q8）in the low thrombotic load group,Cer（d40:0）,PC（20:3₁8:2）,Hex2Cer（d42:1）,etc.upregulated,PC（20:2₂0:4）,PC（18:0₂0:1）,TG（18:1₁8:3₂1:0）,PC（20:1₂2:6）and so on.Compared with the control group,the expressions were down-regulated:PC（29:2）,MePC（33:4）,Cer（d35:4）,etc.in the high thrombus load group,and PA（16:0₁8:2）,MePC in the low thrombus load group（33:4）,PC（29:2）,Cer（d35:4）,etc.,stable angina group TG（15:0₁6:0₂2:6）,PC（18:4₁6:0）,MePC（34:1e）),Cer（d35:4）,etc.④Compared with the stable angina group,the up-regulated expressions are:PC（16:1e₂0:5）,HexlCer（d18:1-20:0）,PE（38:5）,SM（t40:6）in the acute myocardial infarction high thrombus load group),AcCa（22:1）,AcCa（22:0）,PC（19:1-19:1）,CarE（20:0）,PC（42:2）in the low thrombus load group of acute myocardial infarction.The down-regulated expressions are:Cer（d17:0₁8:4）,DG（50:1）,TG（20:0₁8:1₂2:0）in acute myocardial infarction high thrombotic load group,SM（t40:3）,SM（d38:3）in acute myocardial infarction low thrombotic load group.4.The lipidomics results of coronary blood samples and radial artery blood samples under the same thrombus load level are significantly different:such as TG（16:0₁8:1₂4:1）,DG（50:1）,TG（16:0e₁6:0₁8:1）,Hex1Cer（d34:1+O）,TG（15:0₁8:2₂0:5）,PE（12:0e₂2:1）,etc.Cer（d17:0₁8:4）in the stable angina group,PE（38:5）,Hexl Cer（d18:1₂0:0）,TG（36:2e）,Cer（d17:0₁8:4）,PC（20:1e₂0:4）,in the acute myocardial infarction low thrombotic load group PC（35:4e）,Cer（d42:0）,Cer（d42:1+O）,MePC（19:2）,MePC（30:4）,PC（29:2）in the acute myocardial infarction high thrombus load group),PC（16:1e₂0:5）,PC（35:4e）,etc.all have statistical differences.Conclusion1.There are significant differences in the expression levels of plasma lipid molecules in patients with coronary thrombosis,and lipid components such as glycerides,glycerophospholipids,and sphingolipids are the most significant.2.Different subdivision components of the same lipid have different effects on coronary thrombosis.The differential expression of lipids in samples in the coronary arteries may more accurately reflect the formation of thrombus load.