Identification of metabolic components of carotid plaque in high‐risk patients utilizing liquid chromatography–tandem mass spectrometry

Objective Carotid atherosclerosis is a chronic progressive vascular disease that can be complicated by stroke in severe cases. Prompt diagnosis and treatment of high‐risk patients are quite difficult due to the lack of reliable clinical biomarkers. This study aimed to explore potential plaque metabolic markers of stroke‐prone risk and relevant targets for pharmacological intervention. Method Carotid intima and plaque sample tissues were obtained from 20 patients with cerebrovascular symptoms of carotid origin. An untargeted metabolomics approach based on liquid chromatography–tandem mass spectrometry was utilized to characterize the metabolic profiles of the tissues. Multivariate and univariate analysis tools were used. Results A total of 154 metabolites were significantly altered in carotid plaque when compared with thickened intima. Of these, 62 metabolites were upregulated, whereas 92 metabolites were downregulated. Support vector machines identified the 15 most important metabolites, such as N‐(cyclopropylmethyl)‐N′‐phenylurea, 9(S)‐HOTrE, ACar 12:2, quinoxaline‐2,3‐dithiol, and l‐thyroxine, as biomarkers for high‐risk plaques. Metabolic pathway analysis showed that abnormal purine and nucleotide metabolism, amino acid metabolism, glutathione metabolism, and vitamin metabolism may contribute to the occurrence and progression of carotid atherosclerotic plaque. Conclusions Our study identifies the biomarkers and related metabolic mechanisms of carotid plaque, which is stroke‐prone, and provides insights and ideas for the precise prevention and targeted intervention of the disease.