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Original research article
Early metabolic response to acute myocardial ischaemia in patients undergoing elective coronary angioplasty
  1. Sara Di Marino1,
  2. Nicola Viceconte2,
  3. Angelo Lembo1,
  4. Vincenzo Summa1,
  5. Gaetano Tanzilli2,
  6. Valeria Raparelli3,
  7. Giovanni Truscelli2,
  8. Enrico Mangieri2,
  9. Carlo Gaudio2 and
  10. Daniel Oscar Cicero1,4
  1. 1IRBM Science Park S.p.A., Pomezia, Italy
  2. 2Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
  3. 3Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
  4. 4Department of Chemical Science and Technology, Università di Roma “Tor Vergata”, Rome, Italy
  1. Correspondence to Prof. Daniel Oscar Cicero; cicero{at}


Objective Balloon-induced transient coronary ischaemia represents a model of myocardial ischaemia and reperfusion. We are interested in the very early systemic metabolic response to this event.

Methods Blood samples of patients with stable angina (SA) were collected before and after coronary angioplasty. Serum metabolic profiles were obtained using nuclear magnetic resonance spectroscopy. Univariate and multivariate analyses were used to investigate changes in metabolite concentrations.

Results Thirty-four consecutive patients with SA, undergoing elective coronary angioplasty at Policlinico Umberto I of Rome, were included in this study. Changes in metabolites concentration induced by balloon occlusion in venous and arterial sera were detected. In both serum types, a significant increase in ketone bodies, 2-hydroxybutyrate, glutamine and O-acetylcarnitine concentration is observed, while alanine, lactate, phenylalanine and tyrosine decreased after intervention. Most significant metabolic changes were detected in arterial serum.

Conclusions Our study points out two main global metabolic changes in peripheral blood after balloon-induced coronary ischaemia: ketone bodies increase and lactate decrease. Both could be related to compensation mechanisms finalised to fulfil heart’s needs after short period of myocardial ischaemia and probably after reperfusion.

  • coronary artery disease
  • biostatistics
  • cardiac catheterization and angiography
  • percutaneous coronary intervention
  • chronic coronary disease

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  • SDM and NV contributed equally.

  • Contributors GT, NV and DOC made substantial contributions to the conception and design of the work. SDM, AL, GT and DOC made substantial contributions to the acquisition, analysis or interpretation of data for the work. SDM, AL, VS, GT, NV, VR, EM, CG and DOC made substantial contribution to the work or revising it critically for important intellectual content and final approval of the version to be published.

  • Funding Collezione Nazionale di Composti Chimici e Centro Screening (CNCCS) Consortium, Grant: Project B, Sp 2, WP4, 2016 ’Metabolic and risk profile of cardiovascular diseases'. Scientific Independence of Young Researchers Program (RBSI14HNVT), funded by Italian Ministry of Education, University and Research (MIUR).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Code 3786 Policlinico Umberto I Roma.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional unpublished data are available for this study.

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