red blood cell fatty acid patterns and acute coronary syndrome红细胞脂肪酸模式和急性冠脉综合征.pdfVIP

Red Blood Cell Fatty Acid Patterns and Acute Coronary Syndrome 1 1 2 1 Gregory C. Shearer , James V. Pottala , John A. Spertus , William S. Harris * 1 Sanford Research/USD: Cardiovascular Health Research Center, Sioux Falls, South Dakota, United States of America, 2 Mid America Heart Institute of Saint Luke’s Hospital and the University of Missouri Kansas City, Kansas City, Missouri, United States of America Abstract Background: Assessment of coronary heart disease (CHD) risk is typically based on a weighted combination of standard risk factors. We sought to determine the extent to which a lipidomic approach based on red blood cell fatty acid (RBC-FA) profiles could discriminate acute coronary syndrome (ACS) cases from controls, and to compare RBC-FA discrimination with that based on standard risk factors. Methodology/Principal Findings: RBC-FA profiles were measured in 668 ACS cases and 680 age-, race- and gender- matched controls. Multivariable logistic regression models based on FA profiles (FA) and standard risk factors (SRF) were developed on a random 2/3rds derivation set and validated on the remaining 1/3rd. The area under receiver operating characteristic (ROC) curves (c-statistics), misclassification rates, and model calibrations were used to evaluate the individual and combined models. The FA discriminated cases from controls better than the SRF (c = 0.85 vs. 0.77, p = 0.003) and the FA profile added significantly to the standard model (c = 0.88 vs. 0.77, p,0.0001). Hosmer-Lemeshow calibration was poor for the FA model alone (p = 0.01), but acceptable for both the SRF (p = 0.30) and combined models (p = 0.22). Misclassi