Analysis of serum phospholipid profiles by liquid chromatography-tandem mass spectrometry in high resolution mode for evaluation of atherosclerotic patients

Atherosclerosis is one of the most frequent etiology for myocardial infarction and death. It is also the main cause of angina pectoris, a perceived symptom that results of a mismatch between myocardial supply and demand, caused by the partial obstruction of the arteries. The correct diagnosis of atherosclerosis can led to a reduction of mortality. In this research, the phospholipids profile of serum samples from patients diagnosed with stable angina and non-ST elevation myocardial infarction (NSTEMI) or unstable angina was obtained by selective solid-phase extraction (SPE) and subsequent LC-QTOF MS/MS analysis in high resolution mode. Comparative statistical analysis allowed finding four potential markers to discriminate between stable angina and NSTEMI/unstable angina: lysoPC(20:5), PC(18:1/18:2), PC(18:0/20:4) and SM(d18:2/14:0). The panel generated by multivariate ROC analysis by combination of the four compounds provided a disease prediction capability in the training set of 70.7 and 66.0% for stable angina and NSTEMI patients, respectively. On the other hand, external validation by application to an independent cohort improved the predictive power for angina stable patients (92.3%), while this was slightly decreased up to 50.0% for NSTEMI/unstable angina patients. In this way, LC-QTOF MS/MS has shown to be a useful strategy for phospholipid profiling in serum and development of tools to aid in clinical diagnostic. 2014 Elsevier B.V. All rights reserved.