Evidence map›Paper›PMID 31102408›Full record

ArticleEuropean heart journal2019

Serum metabolic signatures of coronary and carotid atherosclerosis and subsequent cardiovascular disease.

Ioanna Tzoulaki, Raphaële Castagné, Claire L Boulangé, Ibrahim Karaman, Elena Chekmeneva, Evangelos Evangelou, Timothy M D Ebbels, Manuja R Kaluarachchi, Marc Chadeau-Hyam, David Mosen and 22 more

Open access · hybridAbstract read
In one paragraph

Article in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 1 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 1 synthesis or guideline pooled it, 175 citations in OpenAlex.

  1. Pooled it
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  13. Serum Metabolites and Heart Failure Risk: MESA and RS.Journal of the American Heart Association · 2025
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30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors at 16 institutions in 7 countries.

Ioanna TzoulakiDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Raphaële CastagnéDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Claire L BoulangéMetabometrix Ltd, Imperial Incubator, Bessemer Building, Prince Consort Road, London, UK.
Ibrahim KaramanDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Elena ChekmenevaDivision of Computational and Systems Medicine, Department of Surgery and Cancer, Imperial College London, South Kensington Campus, London, UK.
Evangelos EvangelouDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Timothy M D EbbelsDivision of Computational and Systems Medicine, Department of Surgery and Cancer, Imperial College London, South Kensington Campus, London, UK.
Manuja R KaluarachchiMetabometrix Ltd, Imperial Incubator, Bessemer Building, Prince Consort Road, London, UK.
Marc Chadeau-HyamDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
David MosenDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Abbas DehghanDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Alireza MoayyeriFarr Institute of Health Informatics Research, University College London Institute of Health Informatics, 222 Euston Road, London, UK.
Diana L Santos FerreiraMRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfiled Grove, Bristol, UK.
Xiuqing GuoDepartment of Pediatrics, Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, USA.
Jerome I RotterDepartment of Pediatrics, Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, USA.
Kent D TaylorDepartment of Pediatrics, Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, USA.
Maryam KavousiDepartment of Epidemiology, Erasmus University Medical Center, University Medical Center Rotterdam, CA Rotterdam, the Netherlands.
Paul S de VriesDepartment of Epidemiology, Erasmus University Medical Center, University Medical Center Rotterdam, CA Rotterdam, the Netherlands.
Benjamin LehneDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Marie LohDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Albert HofmanDepartment of Epidemiology, Erasmus University Medical Center, University Medical Center Rotterdam, CA Rotterdam, the Netherlands.
Jeremy K NicholsonMetabometrix Ltd, Imperial Incubator, Bessemer Building, Prince Consort Road, London, UK.
John ChambersDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Christian GiegerGerman Research Centre for Environmental Health, Helmholtz Zentrum München, Ingolstädter Landstraße 1, D Neuherberg, Germany.
Elaine HolmesMetabometrix Ltd, Imperial Incubator, Bessemer Building, Prince Consort Road, London, UK.
Russell TracyM.D. College of Medicine University of Vermont, The Robert Larner, Given Medical Bldg, E-126, 89 Beaumont Ave, Burlington, VT, USA.
Jaspal KoonerDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA.
Philip GreenlandDepartment of Preventive Medicine, Northwestern University, Feinberg School of Medicine, 680 North Lake Shore Drive, Suite, 1400, Chicago, IL, USA.
Oscar H FrancoDepartment of Medicine, Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, USA.
David HerringtonSection on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA.
John C LindonMetabometrix Ltd, Imperial Incubator, Bessemer Building, Prince Consort Road, London, UK.
Paul ElliottDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, UK.
Imperial College London · GBThe Lundquist Institute · USUK Dementia Research Institute · GBErasmus MC · NLHarvard University · USMRC Centre for Environment and HealthUniversity of Ioannina · GRFarr Institute · GBHelmholtz Zentrum München · DEInserm · FRLondon North West Healthcare NHS Trust · GBNorthwestern University · USUniversity of Bern · CHUniversity of Bristol · GBUniversity of Vermont · USWake Forest University · US

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
Transgenic & Knock-out MouseP30DK063491 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Andrea L Hevener · 2003 to 2026
$40.4M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
Genomic and Proteomic Architecture of AtherosclerosisR01HL111362 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HERRINGTON, DAVID MCLEOD · 2012 to 2021
$17.2M
SNP HEALTH ASSOCIATION RESOURCE (SHARE)N02HL64278 · NHLBI · PI CHIN, SIANG · 2007 to 2007
$9.2M
Metabolomic Signatures of CAD Associated GenotypesR01HL133932 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BOWDEN, DONALD W, HERRINGTON, DAVID MCLEOD · 2016 to 2019
$2.5M
SUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095166 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1999 to 2001
$758k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095162 · HC · JOHNS HOPKINS UNIVERSITY · PI SZKLO, MOYSES A · 1999 to 2000
$694k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095161 · HC · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN · 1999 to 2001
$642k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--FIELD CENTERN01HC095165 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1999 to 2001
$616k
Department of Health HPRU-2012-10141Medical Research Council MR/L01341X/1Medical Research Council MR/L01632X/1NCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1 TR001079NCATS NIH HHS UL1 TR001420NCATS NIH HHS UL1 TR001881NHLBI NIH HHS HHSN268201500003CNHLBI NIH HHS HHSN268201500003INHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS N02 HL064278NHLBI NIH HHS N02 HL64278NHLBI NIH HHS R01 HL111362NHLBI NIH HHS R01 HL133932NIDDK NIH HHS P30 DK063491NIH HHS HHSN263201500003IWellcome Trust 212945/Z/18/Z
6 · The paper itself

Abstract

aimsTo characterize serum metabolic signatures associated with atherosclerosis in the coronary or carotid arteries and subsequently their association with incident cardiovascular disease (CVD). METHODS AND

resultsWe used untargeted one-dimensional (1D) serum metabolic profiling by proton nuclear magnetic resonance spectroscopy (1H NMR) among 3867 participants from the Multi-Ethnic Study of Atherosclerosis (MESA), with replication among 3569 participants from the Rotterdam and LOLIPOP studies. Atherosclerosis was assessed by coronary artery calcium (CAC) and carotid intima-media thickness (IMT). We used multivariable linear regression to evaluate associations between NMR features and atherosclerosis accounting for multiplicity of comparisons. We then examined associations between metabolites associated with atherosclerosis and incident CVD available in MESA and Rotterdam and explored molecular networks through bioinformatics analyses. Overall, 30 1H NMR measured metabolites were associated with CAC and/or IMT, P = 1.3 × 10-14 to 1.0 × 10-6 (discovery) and P = 5.6 × 10-10 to 1.1 × 10-2 (replication). These associations were substantially attenuated after adjustment for conventional cardiovascular risk factors. Metabolites associated with atherosclerosis revealed disturbances in lipid and carbohydrate metabolism, branched chain, and aromatic amino acid metabolism, as well as oxidative stress and inflammatory pathways. Analyses of incident CVD events showed inverse associations with creatine, creatinine, and phenylalanine, and direct associations with mannose, acetaminophen-glucuronide, and lactate as well as apolipoprotein B (P < 0.05).

conclusionMetabolites associated with atherosclerosis were largely consistent between the two vascular beds (coronary and carotid arteries) and predominantly tag pathways that overlap with the known cardiovascular risk factors. We present an integrated systems network that highlights a series of inter-connected pathways underlying atherosclerosis.

Indexed as

AdultAgedCardiovascular DiseasesCarotid Artery DiseasesCoronary Artery DiseaseFemaleHumansMaleMiddle AgedProspective StudiesProton Magnetic Resonance SpectroscopyAtherosclerosisCoronary artery calciumEpidemiological studiesIntima-media thicknessMetabolic phenotypingMetabolomics

Identifiers

PMID31102408
PMCPMC7963131
OpenAlexW2946791903

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.