¹H NMR-derived metabolomics of filtered serum of myocardial ischemia in unstable angina patients

Background: Despite continuing research for development of accurate biomarkers of myocardial ischemia in unstable angina, lack of biochemical biomarkers is alarming. We sought to develop accurate biomarkers using high throughput proton nuclear magnetic resonance (¹H NMR) spectroscopy and filtered serum (lacking proteins and lipoproteins) based metabolomics for detecting myocardial ischemia in unstable angina patients with utmost precision. Methods: Study includes 127 filtered serum samples from myocardial ischemia in unstable angina patients (UA; n = 65) and healthy controls (HC; n = 62). High resolution NMR spectra were obtained to highlight metabolic perturbations of small metabolites. A supervised orthogonal partial least square discriminant analysis was applied to generate a prediction model. Receiver operating characteristic (ROC) curve analysis was performed to reveal the clinical utility of signature biomarkers. Results: Five biomarkers-valine, alanine, glutamine, inosine and adenine-could differentiate 95% of UA from HC with 96% sensitivity and 95% specificity. Conclusions: ¹H NMR-based filtered serum metabolic profiling appears to be an assuring, least invasive and faster way to screen and identify myocardial ischemia in unstable angina patients.