The serum metabolomic profiles of atrial fibrillation patients treated with direct oral anticoagulants or vitamin K antagonists

• DOI: 10.1016/j.lfs.2024.122796
• Publication Date: 2024-06-07T19:28:10Z
• Authors: Alessia Vignoli; Anna Maria Gori; Martina Berteotti; Francesca Cesari; Betti Giusti; Alessia Bertelli; Ada Kura; Elena Sticchi; Emilia Salvadori; Carmen Barbato; Benedetta Formelli; Francesca Pescini; Rossella Marcucci; Leonardo Tenori; Anna Poggesi
• Keywords: Vitamin K antagonist

Long-term oral anticoagulation is the primary therapy for preventing ischemic stroke in patients with atrial fibrillation (AF). Different types of anticoagulant drugs can have specific effects on metabolism patients. Here we characterize, first time, serum metabolomic and lipoproteomic profiles AF treated anticoagulants: vitamin K antagonists (VKAs) or direct anticoagulants (DOACs). Serum samples 167 (median age 78 years, 62 % males, 70 DOACs treatment) were analyzed via high resolution 1H nuclear magnetic resonance (NMR) spectroscopy. Data 25 metabolites 112 lipoprotein-related fractions quantified multivariate univariate statistical approaches. Our data provide evidence that VKAs present significant differences their profiles: lower levels alanine lactate (odds ratio: 1.72 1.84), free cholesterol VLDL-4 subfraction (OR: 1.75), triglycerides LDL-1 1.80) 4 IDL (ORs ∼ 1.80), as well higher HDL 0.48), apolipoprotein A1 0.42) 7 fractions/subfractions (ORs: 0.40–0.51) are characteristic profile DOACs' therapy. results support usefulness NMR-based metabolomics description patient circulating lipoproteins. The observed could contribute to explaining reduced cardiovascular risk, suggesting need further studies this direction fully understand possible clinical implications.