Specific Polypeptide Patterns in Urine Indicate Coronary Artery Disease

A urine test is being developed to diagnose coronary artery disease (CAD), a condition responsible for most of the 1.5 million heart attacks that occur in the United States alone each year.

The urine analysis was performed under routine clinical conditions using capillary electrophoresis-mass spectrometry (CE-MS). Used in combination with a newly generated high-throughput software package, the proteomic approach supported the theory that CAD is reflected in specific polypeptide patterns in urine.

The most reliable test for diagnosing CAD is angiography, an invasive test in which doctors inject special dyes into the body to visualize, via X-rays, fatty plaque deposits in the arteries of the heart. However, the technique is invasive, expensive, time-consuming, and may miss CAD in its earliest stages. It is also potentially dangerous. To develop a faster, more convenient test, scientists collected urine samples from a group of 67 patients--41 with CAD and 26 without--and analyzed the samples for differences in protein content.

Using the proteomic method, a group of 17 peptides were identified that appear to be directly associated with CAD. These urine-based peptides indicated the presence of the disease with an accuracy rate of 84% when compared to CAD cases confirmed using angiography.

Prof. Karlheinze Peter, from the Baker Heart Institute (Melbourne, Australia), and colleagues performed the pilot study, which was reported in the November 19, 2008, issue of the journal Proteome Research. They claimed that it is the first test to establish polypeptide patterns in urine that reflect coronary artery disease in patients with angina-typical symptoms.

The scientists noted that the effect of renal impairment on the established polypeptide pattern needed to be further evaluated before the urine proteome analysis can be used as a clinically applicable test.

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Baker Heart Institute