Background: Despite the establishment of guidelines for the secondary prevention of coronary artery diseases, many patients still develop restenosis after stent implantation. Therefore, novel and noninvasive serum biomarkers that can identify restenosis-prone conditions are necessary to improve the follow-up and treatment of patients with coronary artery disease. Of late, considerable attention is being focused on metabolomics, which is the comprehensive analysis of low-molecular-weight metabolites. This study investigated the use of serum metabolomics in the identification of biomarkers of restenosis.
Methods and results: Gas chromatography/mass spectrometry was used to obtain the serum metabolomic profiles of male patients hospitalized for follow-up coronary angiography 6 months after stent implantation; 23 patients presented with major restenotic lesions (≥75% obstruction), 47 with minor restenotic lesions (≤50% obstruction), and 16 with de novo atherosclerotic lesions. Of 83 serum metabolites analyzed, molecules - isobutylamine, sarcosine, homoserine, ribulose, taurine, glutamine, glucose, and tryptophan - in the major restenosis group were significantly different from those in the minor restenosis group. Differences in correlation among these metabolites imply possible alternations in the activated metabolic pathways.
Conclusions: This study provides the first line of evidence for the use of serum metabolic profiling in the identification of specific biomarkers of stent restenosis.