Alterations in lipid metabolism mediated by oxidative stress play a key role in the process of atherosclerosis and superimposed thrombosis; these can lead to acute coronary syndrome (ACS) and acute ischemic stroke (AIS). Multiple studies have shown that the formation of atheromatous lesions is initiated by oxidation of low-density lipoproteins incorporated into the intima of the vessel wall. Here, we studied lipids in plasma samples from three cohorts: 61 patients with ACS (group A), 49 patients with AIS (group D), and 82 controls (group K). Untargeted lipidomics based on high-performance liquid chromatography coupled to mass spectrometry (UHPLC-HRMS) was employed to obtain comprehensive information on whether relationships exist between these patient categories based on lipid patterns. In addition, malondialdehyde (MDA) as a standard marker of oxidative stress was monitored. The most characteristic lipids in group K were fatty acyls of hydroxyfatty acids (FAHFAs). As expected, MDA concentrations were the lowest in group K. Our findings can better explain ongoing pathologies, both acute and chronic, with the potential for future diagnosis and treatment.

Comprehensive Stroke Center 1st Faculty of Medicine Charles University Prague and Military University Hospital U Vojenské Nemocnice 1200 169 00 Prague Czech Republic

Department of Food Chemistry and Analysis University of Chemistry and Technology Technická 3 166 28 Prague Czech Republic

Department of Medicine 1st Faculty of Medicine Charles University Prague and Military University Hospital U Vojenské Nemocnice 1200 169 00 Prague Czech Republic

Institute of Hematology and Blood Transfusion Prague U Nemocnice 2094 128 20 Prague Czech Republic

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