Relationship between metabolites of arachidonic acid and prognosis in patients with acute coronary syndrome

Objective: To investigate the correlation of arachidonic acid (ARA) metabolites and prognosis in ACS patients. Methods and results: This is a mono-center retrospective nested case-control study. We followed up 470 ACS patients, of whom 39 patients had MACE in a mean follow up time of 1037 days (identified as MACE group). Another 39 clinically matched patients without MACE were selected from the 470 ACS patients (Non-MACE group). Thirty-nine subjects without Coronary Heart Disease were enrolled as Control group. Metabolites of ARA were determined by LC-MS/MS. We found that plasma levels of LTB4, 8-HETE, 11-HETE, 12-HETE, and 15-HETE were significantly increased in MACE and Non-MACE groups, 5-HETE and 9-HETE were significantly increased in MACE group comparing with Control group (P < 0.05). Importantly, plasma level of 19-HETE in MACE group was significantly lower than Non-MACE and Control groups. 19-HETE significantly correlated with the prognosis of ACS after adjustment for clinical characteristics (HR = 0.103, 95% C.I.: 0.014-0.766). The AUC for ROC curve of 19-HETE in predicting MACE was 0.637 (P < 0.05). Survival analysis showed that ACS patients with 19-HETE levels higher than 0.13 ng/ml tend to have better prognosis than those lower than 0.13 ng/ml (P < 0.05). GRACE score and serum Fib levels were also significantly correlated with MACE. 20-HETE level was found significantly higher in STEMI group comparing with NSTE-ACS group (P < 0.05). Conclusion: Plasma arachidonic acid metabolites may act as prognostic markers for ACS patients. (C) 2016 Elsevier Ltd. All rights reserved.