The following is a summary of ‘’TCA cycle metabolites associated with adverse outcomes after acute coronary syndrome: mediating effect of renal function,” published in the June 2023 issue of Cardiology by Gimenez et al.
Researchers performed a retrospective study to investigate tricarboxylic acid (TCA) cycle metabolites’ linked to cardiovascular events and mortality after acute coronary syndrome (ACS) and the mediating effect of renal function.
In this prospective study, 309 patients with ACS were followed for an average of 6.7 years. Among them, 131 experienced major adverse cardiovascular events (MACE), such as heart attacks, heart failure hospitalizations, and all-cause mortality, and 90 deaths were recorded. The study analyzed plasma concentrations of various metabolites using liquid chromatography with tandem mass spectrometry (LC-tandem MS). Hazard ratios were calculated using multivariable Cox regression models, and a mediation analysis was conducted to examine the potential role of the estimated glomerular filtration rate (eGFR) in mediating the observed outcomes.
Positive associations were found between isocitrate and major adverse cardiovascular events (HR per 1 SD, 1.25; 95% CI: 1.03, 1.50) and between aconitate, isocitrate, d/l-2-hydroxyglutarate and all-cause mortality (HR per 1 SD, 1.41; 95% CI: 1.07, 1.84; 1.58; 95% CI: 1.23, 2.02; 1.38; 95% CI: 1.14, 1.68). However, these associations lost significance after adjusting for eGFR. Mediation analyses showed that eGFR acts as a strong mediator in these associations.
Study findings highlighted the significance of targeting TCA metabolites and renal function together to prevent complications related to ACS.