TCA cycle metabolites associated with adverse outcomes after acute coronary syndrome: Mediating effects of renal function

To examine relationships of tricarboxylic acid (TCA) cycle metabolites with risk of cardiovascular events and all-cause mortality in 309 patients with acute coronary syndrome (ACS), and determine whether these associations were modified by renal function. We found that higher plasma TCA cycle metabolites including isocitrate, aconitate and d/l-2-hydroxyglutarate were associated with risk of MACE and all-cause mortality in ACS patients. Furthermore, mediation analyses demonstrated that eGFR is a strong mediator of these associations.

本研究旨在探究309例急性冠状动脉综合征（ACS）患者体内三羧酸（TCA）循环代谢物与心血管事件发生风险及全因死亡率的关联，并明确肾功能是否对上述关联存在调节作用。研究结果显示，血浆中较高水平的三羧酸循环代谢物（包括异柠檬酸、顺乌头酸及d/l-2-羟基戊二酸）与ACS患者的主要不良心血管事件（MACE）发生风险及全因死亡率显著相关。此外，中介分析证实eGFR是上述关联的强中介变量。