Changes to the serum lipidome and their relation to coronary plaque in the first six months after acute myocardial infarction.

BACKGROUND AND AIMS: The measurement of lipid species in blood holds promise for identifying new biomarkers associated with coronary atherosclerosis. Here, we examined for relationships between circulating lipid species and coronary plaque changes following acute myocardial infarction (MI) in patients on guideline-recommended treatment.

METHODS

In this post-hoc analysis of the INFLAME study, patients presenting with MI underwent serum lipidomic analysis and coronary computed tomography angiography (CCTA) during admission and at 6-month follow-up. Quantitative CCTA plaque analysis was performed on the highest-grade, non-culprit stenosis. A hybrid targeted/untargeted liquid chromatography mass spectrometry strategy was used to identify changes in lipids associated with plaque measurements.

RESULTS

48 paired samples from 24 participants with complete imaging and biochemical datasets formed the study basis. Two sphingolipid classes, sphingomyelin (SM) (p.adj<0.001) and ceramides (Cer) (p.adj = 0.02) decreased post-MI as measured by percentage composition of the total serum lipid pool, whereas the lysolipids, lysophosphatidylcholine (LPC) (p.adj<0.001) and lysophosphatidylethanolamine (LPE) (p.adj = 0.04) increased. In multivariable linear regression analysis, each standard deviation temporal decrease in LPC 15:0 or phosphatidyl choline (PC) 39:6 associated with >4 % decreases in total plaque burden. Furthermore, reduction of LPC 15:0 associated with enhanced reduction in low-attenuation plaque burden, and reductions of LPC 18:0 and PC 39:6 with greater reduction of non-calcified plaque burden. Similarly, each standard deviation reduction in the sphingolipids, Cer d43:1 and SM d38:2, associated with >4 % decreases in low-attenuation plaque composition.

CONCLUSION

In the early post-MI period, guideline-recommended treatment is accompanied by decreases in sphingolipids, increases in lysolipids, and alterations in the fatty acid composition of lipid subclasses, with some lipidomic changes associating with favorable changes in coronary plaque characteristics.