Background: Acute myocardial infarction (AMI) is a serious medical
emergency and leading cause of cardiac-related deaths worldwide. The devastating
outcome is sudden death of the patient within first few hours from the onset of
symptoms. The rapid detection of physiological transformations associated with
AMI coupled with instant treatment to reset these changes and monitoring response
to treatment can greatly decrease the mortality and morbidity of patients.
Objective: To establish the early hour metabolomic signatures in the sera of AMI
Methodology: Metabolic profiles of sera collected from 42 AMI patients
(immediately after the myocardial infarction) and 38 age/sex matched normal
controls were obtained using high-resolution 1D 1H CPMG and diffusion edited NMR spectra. The
metabolic profiles were compared using multivariate statistical analysis to identify the disease specific
metabolic disturbances associated with AMI and, therefore, the perturbed biochemical pathways in this
Results: Our results revealed significant metabolic perturbations in AMI compared to control cohorts.
The upregulated metabolites in AMI condition include arginine, glycine, tyrosine, phenylalanine, glucose,
creatine, creatinine, lactate, N-acetyl glycoproteins and phospholipids, while the levels of amino
acids (such as valine, alanine, glutamate, glutamine, threonine and methionine), citrate, acetone, choline,
glycero-phosphocholine, trimethylamine-N-oxide and lipids/fatty acids were decreased. Receiver operating
curve characteristics (ROC) confirmed the robustness and validity of these metabolic markers.
Conclusion: The resulted metabolic profiling provided new insights into the metabolic processes involved
in acute myocardial infarction. Further, we foresee that these changes would aid rapid clinical
evaluation of myocardial infarction in emergency and its timely management.