While scientists have suspected that metabolites, the molecular debris left over after the body breaks food down into energy sources and building blocks of cells and tissues, may be useful in diagnosing disease, these small molecules have remained difficult to identify, quantify, and characterize.  Svati Shah, from Duke University Medical Center (North Carolina, USA), and colleagues, who previously have elucidated that metabolic profiles associated with early-onset coronary artery disease are inheritable, have identified specific metabolic profiles associated with coronary artery disease, heart attacks and death among patients who have undergone coronary catheterization.   The researchers analyzed data catalogued in Duke's CATHGEN biorepository, which holds health records and blood samples from nearly 10,000 patients who had come to Duke over the past eight years for catheterization.  Of these patients, the team then selected 174 patients who had experienced early-onset coronary artery disease (CAD), and compared them to 174 controls who had undergone catheterization but who were not found to have CAD. Using a panel of 69 metabolites previously identified as potentially involved in the development of CAD, they examined the metabolic profiles in both groups. The researchers identified two clusters of metabolites that differentiated the two groups, then via multiple analytic and statistical methods, they found that the two factors that were clearly associated with coronary artery disease, with one factor predicative of increased risk of heart attack or death among patients with coronary artery disease. The researchers conclude that: “Metabolite profiles are associated with [coronary artery disease] and subsequent cardiovascular events.”