Objective To explore the correlation between serum metabolomics characteristics and the risk of myocardial infarction in patients with coronary atherosclerosis(CAS)so as to provide new ideas and targets for clinical prevention and treatment of myocardial infarction.Methods A total of 180 CAS patients treated in our hospital from June 2018 to June 2022 were selected as the study subjects and divided into control group(non-myocardial infarction,n=138)and observation group(myocardial infarction,n=42)according to follow-up.Propensity score matching method was used to perform 1∶1 matching,and a total of 34 pairs were successfully matched.The serum samples of patients were detected by mass spectrometry chip in metabolomics technology.Principal component analysis(PCA),partial least square discriminant analysis(PLS-DA),and orthogonal partial least square discriminant analysis(OPLS-DA)results were compared among groups to screen out different metabolites.The diagnostic value of differential metabolites was evaluated by receiver operating characteristic(ROC)curve.The samples were cluster analyzed by agglomerative hierarchical clustering,and the pathway enrichment analysis of differential metabolites was carried out.Results There were significant differences in the mass spectra of serum samples from the two groups of CAS patients.PC A results showed that there was a certain separation trend between the overall level of serum metabolism in the two groups,but the trend was not significant(R2X=0.654,Q2Y=0.719).PLS-DA analysis showed the separation trend of the two groups of samples(R2X=0.582,R2Y=0.810,Q2Y=0.675).Further OPLS-DA analysis showed that the two groups of samples had an obvious separation trend(R2X=0.595,R2Y=0.831,Q2Y=0.742).Twelve differential metabolites between groups were screened by VIP value＞1 and Wilcoon-Mann-Whitney test;of them three were upregulated and nine were downregulated.Upregulated D-glucose and downregulated glycocholic acid,ursodeoxycholic acid,nicotinic acid acid,niacinamide and succinic acid were of high value as diagnostic markers for myocardial infarction.Differential metabolite pathway analysis showed that among the eight metabolic pathways that may be disturbed by differential metabolites,non-alcoholic fatty liver,niacin and niacinamide metabolism,and pathways associated with type 2 diabetes mellitus Impact ≥ 0.1 might be potential pathways in the pathogenesis of myocardial infarction in CAS patients.Conclusion Serum levels of glycinocholic acid,D-glucose,ursodeoxycholic acid,niacin,niacinamide,and succinic acid can be used as potential markers to distinguish the risk of myocardial infarction in patients with CAS.The metabolic pathways affected mainly include non-alcoholic fatty liver disease,niacin and niacinamide metabolism,and type 2 diabetes mellitus-related pathways.

Objective To explore the correlation between serum metabolomics characteristics and the risk of myocardial infarction in patients with coronary atherosclerosis(CAS)so as to provide new ideas and targets for clinical prevention and treatment of myocardial infarction.Methods A total of 180 CAS patients treated in our hospital from June 2018 to June 2022 were selected as the study subjects and divided into control group(non-myocardial infarction,n=138)and observation group(myocardial infarction,n=42)according to follow-up.Propensity score matching method was used to perform 1∶1 matching,and a total of 34 pairs were successfully matched.The serum samples of patients were detected by mass spectrometry chip in metabolomics technology.Principal component analysis(PCA),partial least square discriminant analysis(PLS-DA),and orthogonal partial least square discriminant analysis(OPLS-DA)results were compared among groups to screen out different metabolites.The diagnostic value of differential metabolites was evaluated by receiver operating characteristic(ROC)curve.The samples were cluster analyzed by agglomerative hierarchical clustering,and the pathway enrichment analysis of differential metabolites was carried out.Results There were significant differences in the mass spectra of serum samples from the two groups of CAS patients.PC A results showed that there was a certain separation trend between the overall level of serum metabolism in the two groups,but the trend was not significant(R2X=0.654,Q2Y=0.719).PLS-DA analysis showed the separation trend of the two groups of samples(R2X=0.582,R2Y=0.810,Q2Y=0.675).Further OPLS-DA analysis showed that the two groups of samples had an obvious separation trend(R2X=0.595,R2Y=0.831,Q2Y=0.742).Twelve differential metabolites between groups were screened by VIP value＞1 and Wilcoon-Mann-Whitney test;of them three were upregulated and nine were downregulated.Upregulated D-glucose and downregulated glycocholic acid,ursodeoxycholic acid,nicotinic acid acid,niacinamide and succinic acid were of high value as diagnostic markers for myocardial infarction.Differential metabolite pathway analysis showed that among the eight metabolic pathways that may be disturbed by differential metabolites,non-alcoholic fatty liver,niacin and niacinamide metabolism,and pathways associated with type 2 diabetes mellitus Impact ≥ 0.1 might be potential pathways in the pathogenesis of myocardial infarction in CAS patients.Conclusion Serum levels of glycinocholic acid,D-glucose,ursodeoxycholic acid,niacin,niacinamide,and succinic acid can be used as potential markers to distinguish the risk of myocardial infarction in patients with CAS.The metabolic pathways affected mainly include non-alcoholic fatty liver disease,niacin and niacinamide metabolism,and type 2 diabetes mellitus-related pathways.