Differential modulation of polyunsaturated fatty acids in patients with myocardial infarction treated with ticagrelor or clopidogrel

Abstract

Untargeted metabolomics is used to refine the development of biomarkers for the diagnosis of cardiovascu-lar disease. Myocardial infarction (MI) has major individual and societal consequences for patients, whoremain at high risk of secondary events, despite advances in pharmacological therapy. To monitor their dif-ferential response to treatment, we performed untargeted plasma metabolomics on 175 patients from theplatelet inhibition and patient outcomes (PLATO) trial treated with ticagrelor and clopidogrel, two commonP2Y12inhibitors. We identified a signature that discriminates patients, which involves polyunsaturated fattyacids (PUFAs) and particularly the omega-3 fatty acids docosahexaenoate and eicosapentaenoate. Theknown cardiovascular benefits of PUFAs could contribute to the efficacy of ticagrelor. Our work, beyondpointing out the high relevance of untargeted metabolomics in evaluating response to treatment, establishesPUFA metabolism as a pathway of clinical interest in the recovery path from MI.