AUTHOR=Le D. Elizabeth , García-Jaramillo Manuel , Bobe Gerd , Alcazar Magana Armando , Vaswani Ashish , Minnier Jessica , Jump Donald B. , Rinkevich Diana , Alkayed Nabil J. , Maier Claudia S. , Kaul Sanjiv TITLE=Plasma Oxylipins: A Potential Risk Assessment Tool in Atherosclerotic Coronary Artery Disease JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=Volume 8 - 2021 YEAR=2021 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.645786 DOI=10.3389/fcvm.2021.645786 ISSN=2297-055X ABSTRACT=Background: While oxylipins have been linked to coronary artery disease (CAD), little is known about their diagnostic and prognostic potential. Objective: We tested whether plasma concentration of specific oxylipins may discriminate among number of diseased coronary arteries and predict median 5-yr outcomes in symptomatic adults. Methods: Using a combination of high-performance liquid chromatography (HPLC) and quantitative tandem mass spectrometry, we conducted a targeted analysis of 39 oxylipins in plasma samples of 23 asymptomatic adults with low CAD risk and 74 symptomatic adults (≥70% stenosis), aged 38-87 from the Greater Portland, Oregon, area. Concentrations of 22 oxylipins were above the lower limit of quantification in >98% of adults and were compared, individually and in groups based on precursors and biosynthetic pathways, in symptomatic adults to number of diseased coronary arteries (1: n=31; 2: n=23; 3: n=20), and outcomes during a median 5-yr follow-up (no surgery: n=7; coronary stent placement: n=24; coronary artery bypass graft surgery: n=26; death: n=7). Results: Plasma levels of 6 quantified oxylipins decreased with the number of diseased arteries; a panel of 5 oxylipins diagnosed 3 diseased arteries with 100% sensitivity and 70% specificity. Concentrations of 5 oxylipins were lower and 1 oxylipin was higher with survival; a panel of 2 oxylipins predicted survival during follow-up with 86% sensitivity and 91% specificity. Conclusions: Quantification of plasma oxylipins may assist in CAD diagnosis and prognosis in combination with standard risk assessment tools.