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Acute coronary syndrome (ACS) is a clinical condition caused by a disturbance in myocardial blood flow. ACS can be basically divided into two forms: ST elevation myocardial infarction (STEMI) due to complete occlusion of the coronary artery and non-ST elevation myocardial infarction (NSTEMI) due to partial occlusion of the coronary artery. In this study, we aimed to monitor the metabolite profile of STEMI and NSTEMI patients and compare the results via untargeted metabolomics approach. Serum samples were collected from STEMI and NSTEMI patients, and each group consists of 20 participants. Extraction was achieved by acetonitrile, and chromatographic separation was performed by LC/Q-TOF/MS/MS accompanied with dual AJS ESI positive ion mode. METLIN, MATLAB 2017a-PLS Toolbox7.2, and Human Metabolome Database were utilized for bioinformatics evaluation of obtained findings. In our results, 203 m/z ratio was detected and 163 m/z ratio passed the significance criteria (fold analysis > 1.5 and p < 0.05). Twenty-five metabolites including BCAAs, LysoPC species, lactic acid, succinate, malonic acid, maleic acid, butyric acid, carnitine, and betaine were identified. In conclusion, new biomarker candidates were identified to differentiate the diagnosis of STEMI and NSTEMI. Identified metabolites are indicative of alterations in oxidative stress, hypoxia, TCA cycle, and amino acid metabolism.

Investigation of the metabolic difference between ST-elevated myocardial infarction and non-ST-elevated myocardial infarction via LC/Q-TOF/MS/MS