Lipidomics Facilitates the Discovery of Diagnostic Biomarkers in Patients with Chronic Total Occlusion during the Perioperative Period

Chronic total occlusion (CTO) is
a subtype of cardiovascular disease associated with high mortality
and an increased risk of ventricular arrhythmia. This study aimed
to investigate lipidomic changes in CTO patients undergoing percutaneous
coronary intervention (PCI) using a tandem-lipidomic strategy. We
first applied a global lipidomic approach to identify the serum lipidomes
of CTO-PCI patients during the perioperative period, successfully
separating and identifying over 1500 lipids. Based on these results,
a multiple reaction monitoring (MRM) quantification method was developed
and employed for targeted lipidomic analysis. Using a high-throughput
MRM tandem liquid chromatography–mass spectrometry approach,
613 lipids were successfully quantified in CTO-PCI patients and control
donors. The lipid profile of PAs has surfaced as a potential biomarker
that can help tell CTO patients apart from individuals suspected of
having the conditional biomarker for distinguishing CTO patients from
those suspected of having the condition. Notably, patients with different
prognostic outcomes exhibited significantly distinct serum lipidomes
in both pre- and post-CTO-PCI samples. This finding suggests that
lipidomic data hold significant potential for both monitoring postoperative
prognosis and predicting surgical outcomes.