• You Zhou, Jinxiang Chen, Su Li, Ao Chen, Chunfeng Dai, Muyin Liu, Danbo Lu, Zhangwei Chen, Xiangdong Wang, Juying Qian, and Junbo Ge.
• Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University; National Clinical Research Center for Interventional Medicine; Shanghai Clinical Research Center for Interventional Medicine, Shanghai, People's Republic of China.
• Eur. J. Clin. Invest. 2022 Nov 1; 52 (11): e13826e13826.

BackgroundPredictors of prognosis in patients with coronary chronic total occlusion (CTO) undergoing elective percutaneous coronary intervention (PCI) have remained lacking. Lipidomic profiling enables researchers to associate lipid species with disease progression and may improve the prediction of cardiovascular events.MethodsIn the present study, 781 lipids were measured by targeted lipidomic profiling in 350 individuals (50 healthy controls, 50 patients with coronary artery disease and 250 patients with CTO). L1-regularized logistic regression was used to identify lipid species associated with adverse cardiovascular events and create predicting models, which were verified by 10-fold cross-validation (200 repeats). Comparisons were made between a traditional model constructed with clinical characteristics alone and a combined model built with both lipidomic data and traditional factors.ResultsTwenty-four lipid species were dysregulated exclusively in patients with CTO, most of which belonged to sphingomyelin (SM) and triacylglycerol (TAG). Compared with traditional risk factors, new model combining lipids and traditional factors had significantly improved performance in predicting adverse cardiovascular events in CTO patients after PCI (area under the curve, 0.870 vs. 0.726, p < .05; Akaike information criterion, 129 versus 156; net reclassification improvement, 0.312, p < .001; integrated discrimination improvement, 0.244, p < .001). Nomogram was built based on the incorporated model and proved efficient by Kaplan-Meier method.ConclusionsLipidomic profiling revealed lipid species which may participate in the formation of CTO and could contribute to the risk stratification in CTO patients undergoing PCI.© 2022 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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