CN110914453B - Biomarkers for atherosclerotic cardiovascular disease - Google Patents

Biomarkers for atherosclerotic cardiovascular disease Download PDF

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CN110914453B
CN110914453B CN201780093309.1A CN201780093309A CN110914453B CN 110914453 B CN110914453 B CN 110914453B CN 201780093309 A CN201780093309 A CN 201780093309A CN 110914453 B CN110914453 B CN 110914453B
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揭著业
夏慧华
梁穗莎
贾慧珏
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Abstract

Use of a biomarker in predicting the risk of an atherosclerotic cardiovascular disease or a related disorder thereof and a method of predicting the risk of an atherosclerotic cardiovascular disease or a related disorder thereof.

Description

Biomarkers for atherosclerotic cardiovascular disease
Technical Field
Embodiments of the present disclosure relate generally to the field of biological detection, and more particularly, to biomarkers, use of the biomarkers in predicting the risk of an atherosclerotic cardiovascular disease or related condition thereof, methods of predicting the risk of an atherosclerotic cardiovascular disease or related condition thereof, and kits for predicting the risk of an atherosclerotic cardiovascular disease or related condition thereof.
Background
Atherosclerotic cardiovascular disease (ACVD) is generally caused by the build-up of plaque on the arterial wall, especially on the large and medium-sized arteries serving the heart (i.e., atherosclerosis). It refers to the following conditions: coronary Heart Disease (CHD), cerebrovascular disease, peripheral arterial disease, and aortic atherosclerosis. These conditions have similar causes, mechanisms and methods of treatment.
The "gold standard" for detecting ACVD is invasive coronary angiography. However, this is expensive and may present a risk to the patient. Prior to angiography, non-invasive diagnostic modalities such as Myocardial Perfusion Imaging (MPI) and CT angiography can be used, but they have complications including radiation exposure, contrast agent sensitivity, and only moderately increase the recognition rate of obstructive ACVD.
Prior knowledge suggests that genetic factors, environmental factors, and interactions thereof, together induce complex phenotypes and many diseases. In recent years, GWAS (whole genome association research) has conducted an increasing study of ACVD and revealed 10.6% of endogenous etiologies caused by 46 common variants (ehset, g.b. et al Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk. Nature 478,103-109, incorporated herein by reference). However, we still need to further understand the contribution of genes to disease.
Our "forgetting organs", the intestinal microbiota, plays a vital role in our health in many ways, such as harvesting energy from food, producing important metabolites, promoting development and maturation of the immune system, and protecting the host from pathogen infection, etc. Recent studies have shown the presence of dysbacterioses, chronic inflammation and metabolic abnormalities in the gut of certain metabolic diseases (e.g. diabetes, obesity and coronary artery disease). A recent study showed that intestinal microorganisms can metabolize red meat component (L-carnitine, phosphatidylcholine, cholesterol) to TMA, which is then further oxidized to TMA O in the liver, causing oxidation reactions in the blood vessels, leading to inflammation and lipid deposition, ultimately leading to atherosclerosis and coronary heart disease (Koeth, R.A. et al Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, proteins atherosclerosis. Nature medium 19,576-585, incorporated herein by reference). These studies indicate that deregulation of the intestinal microbial content can strongly influence the pathogenesis of ACVD by inducing metabolic abnormalities in humans. However, the lack of a large study cohort for the macrogenomic characterization of this ACVD main population prevents further studies of the effects exerted by microbiomes.
Disclosure of Invention
Embodiments of the present disclosure seek to at least somewhat address at least one of the problems existing in the prior art, or to provide consumers with a useful commercial choice.
Embodiments of the first broad aspect of the present disclosure provide a biomarker, wherein the biomarker comprises the amino acid sequence as set forth in SEQ ID NO: 1-3.
ATGAATTGTGAAACTGTTGCCCTCGGGTCGTTTTGCAAGTTGAAGTCGAGGAGAGGAAAAAAACAAAAAGGAGAAATACTCATGGCAGTAATTTCAATGAAACAACTTCTTGAGGCTGGTGTACACTTTGGTCACCAAACTCGTCGCTGGAACCCTAAGATGGCTAAGTACATCTTCACTGAGCGTAACGGAATCCACGTTATCGACTTGCAACAAACTGTAAAATATGCTGACCAAGCTTACGATTTCATGCGTGATGCAGCAGCTAACGATGCAGTTGTATTGTTCGTTGGTACTAAGAAACAAGCCGCAGATGCAGTTGCTGAAGAAGCTGTTCGTGCAGGACAATACTTCATCAACCACCGTTGGTTGGGTGGAACTCTTACTAACTGGGGAACTATCCAAAAACGTATCGCTCGTTTGAAAGAAATCAAACGTATGGAAGAAGAAGGAATCTTCGACGTTCTTCCTAAGAAAGAAGTTGCACTTCTTAATAAACAGCGTGCACGTCTTGAAAAATTCTTGGGTGGTATCGAAGACATGCCTCGTATCCCAGATGTAATGTACGTAGTTGACCCACATAAAGAGCAAATCGCTGTTAAAGAAGCTAAAAAATTGGGTATCCCAGTTGTAGCGATGGTTGACACAAACACTGATCCAGACGATATCGATGTAATCATCCCAGCTAACGATGACGCTATCCGCGCGGTTAAACTGATCACAGCTAAATTGGCTGACGCTATCATCGAAGGACGTCAAGGTGAAGATGCAACAGCAGTTGAAGCAGAATTTGCAGCTTCAGAAGCTCAAGCAGACTCAATCGAAGAAATCGTTGAAGTTGTAGAAGGCGACAACGCTTAA(SEQ ID NO:1).
TTGGCAATTAACGCACAAGAAATCAGCGCTTTAATTAAGCAACAAATTGAAAATTTCAAACCCAATTTTGATGTGACTGAAACAGGTGTTGTAACCTATATCGGGGACGGTATCGCGCGTGCTCACGGCCTTGAAAATGCCATGAGTGGAGAGTTGTTGATTTTTGAAAACGGCTCTTATGGTATGGCTCAAAACTTGGAGTCAACAGATGTTGGTATTATCATCCTAGGTGACTTTACAGATATCCGTGAAGGTGATACAATTCGCCGTACAGGTAAAATCATGGAAGTCCCAATAGGTGAAAGTCTGATTGGTCGTGTTGTGGATCCTCTTGGTCGTCCAGTTGACGGTCTTGGAGAAATCCACACTGATAAAACTCGTCCAGTTGAAGCGCCAGCTCCTGGTGTTATGCAACGTAAGTCTGTATCAGAACCATTGCAAACTGGTTTGAAAGCTATCGACGCCCTTGTACCGATTGGTCGTGGTCAACGTGAGTTGATTATCGGTGACCGTCAGACAGGGAAAACAACTATTGCGATTGATACAATCTTGAACCAAAAAGGTCAAGATATGATCTGTATTTATGTCGCTATTGGACAAAAAGAATCAACAGTTCGTACGCAAGTAGAAACACTACGTCAGTACGGTGCCTTGGACTACACAATCGTTGTGACTGCCTCTGCTTCACAACCATCTCCATTGCTTTTCCTAGCTCCTTATGCTGGGGTTGCCATGGCGGAAGAATTTATGTACCAAGGCAAGCATGTTTTGATCGTTTATGATGATCTTTCAAAACAAGCGGTCGCTTATCGTGAACTTTCTCTCTTGCTTCGTCGTCCACCAGGTCGTGAAGCCTTCCCAGGGGATGTTTTCTACCTTCACAGCCGTTTGCTTGAGCGC(SEQ ID NO:2).
AAGGCACTCGAGGGAGCGCTCCGCGACCTCACCGCGATCACCGGCCAGAAGCCCGTGACCACCCGCGCCAAGAAGTCCATCGCGCAGTTCAAGCTGCGTGAGGGCCAGGCGATCGGTGCGCACGTCACGCTTCGCGGCGACCGCATGTGGGAGTTCCTGGATCGCCTCCTCTCGACGGCGCTTCCCCGTATCCGTGACTTCCGCGGACTGTCCTCCAAGCAGTTCGACGGTCACGGCAATTACACCTTCGGTCTCACGGAACAGTCGATGTTCCACGAGATCGATCAGGACTCGATCGACCGAGTGCGCGGCATGGACATCACGGTTGTCACCTCGGCCACCACCGACGAAGAGGGTCGCGCCCTTCTCCGTCACCTCGGCTTCCCGTTCAAGGAGGACTGA(SEQ ID NO:3)。
The inventors have surprisingly found that genes in the gut microbiota described above can be effectively used as biomarkers for predicting the risk of atherosclerotic cardiovascular disease or related conditions thereof.
Embodiments of the second broad aspect of the present disclosure provide the use of the above biomarker in predicting the risk of an atherosclerotic cardiovascular disease or associated condition thereof.
Embodiments of the third broad aspect of the present disclosure provide a method of predicting the risk of an atherosclerotic cardiovascular disease or associated condition thereof. According to an embodiment of the invention, the method comprises: (1) Determining the relative abundance of the above-described biomarker in a sample of a test subject; (2) Predicting the risk of an atherosclerotic cardiovascular disease or a related condition thereof based on the relative abundance of the biomarker. The above method can effectively predict the risk of atherosclerotic cardiovascular disease or its related condition. The reliability of the prediction result is high.
Embodiments of the fourth broad aspect of the present disclosure provide a kit for predicting the risk of an atherosclerotic cardiovascular disease or associated condition thereof. According to an embodiment of the invention, a kit comprises: a reagent configured to detect the biomarker. The kit finds use in effectively and easily predicting the risk of atherosclerotic cardiovascular disease or a related condition thereof.
The above summary of the present disclosure is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The figures and the detailed description that follow more particularly exemplify illustrative embodiments.
Additional aspects and advantages of embodiments of the disclosure will be set forth in part in the description which follows and, in part, will be obvious from the description, or may be learned by practice of embodiments of the disclosure.
Detailed Description
Reference will be made in detail to embodiments of the present disclosure. The embodiments described herein with reference to the drawings are illustrative, exemplary, and serve to generally understand the disclosure. The embodiments should not be construed as limiting the disclosure. Throughout the specification, identical or similar elements and elements having identical or similar functions are denoted by similar reference numerals.
Biomarkers
Embodiments of the first broad aspect of the present disclosure provide a biomarker, wherein the biomarker comprises the amino acid sequence as set forth in SEQ ID NO: 1-3. The inventors have surprisingly found that genes in the gut microbiota described above can be effectively used as biomarkers for predicting the risk of atherosclerotic cardiovascular disease or related conditions thereof.
The assessment and characterization of the intestinal microbial content has become a major area of research in human diseases including ACVD. To analyze the intestinal microbial content in ACVD, the inventors performed a protocol of metagenomic association analysis (MGWAS) (Qin, j. Et al a methonom-wide association study of gut microbiota in type 2 diabetes.Nature 490,55-60 (2012), incorporated herein by reference) based on deep shotgun sequencing of intestinal microbial DNA from 405 chinese individuals (n=218 ACVD,187 healthy controls; table 1). The present inventors identified and validated 3 gene markers associated with ACVD. To explore the diagnostic value of fecal microbial genes for ACVD, the inventors constructed random forest classifiers from 405 ACVD and control samples, performed 5-fold cross-validation of 5 replicates, and identified 3 optimized diseases associated with intestinal microbial gene markers. The present inventors' data provide insight into the characteristics of intestinal metagenome associated with risk of ACVD, examples of future studies of pathophysiological roles of intestinal metagenome in other related diseases, and the usefulness of gut flora-based methods for assessing individuals at risk of such disorders.
Use of biomarkers
Embodiments of the second broad aspect of the present disclosure provide the use of the above biomarker in predicting the risk of an atherosclerotic cardiovascular disease or associated condition thereof.
Method for predicting ACVD risk
Embodiments of the third broad aspect of the present disclosure provide a method of predicting the risk of an atherosclerotic cardiovascular disease or associated condition thereof. According to an embodiment of the invention, the method comprises: (1) Determining the relative abundance of the above-described biomarker in a sample of a test subject; and (2) predicting the risk of atherosclerotic cardiovascular disease or a related condition thereof based on the relative abundance of the above-described biomarkers. The above method can effectively predict the risk of atherosclerotic cardiovascular disease or its related condition. The reliability of the prediction result is high.
According to an embodiment of the disclosure, wherein the relative abundance of the biomarker is obtained by sequencing.
According to an embodiment of the disclosure, step (2) comprises comparing the relative abundance of the biomarker to a preset threshold. In some embodiments of the present disclosure, a sufficient difference between the greater relative abundance and the preset threshold may be indicative of the subject being tested having or at risk of developing an atherosclerotic cardiovascular disease or related condition thereof. As will be appreciated by those skilled in the art, values of "sufficient difference" and "preset value" may be obtained based on known conditions having an atherosclerotic cardiovascular disease or related disorder from some control samples. And according to another embodiment of the present disclosure, the preset threshold is about at least 0.5.
It should be noted that the relative abundance is a true value or probability of relative abundance, where the probability is a probability of atherosclerotic cardiovascular disease by comparing the relative abundance information of the biomarkers in the subject sample to the training dataset using a multivariate statistical model.
According to an embodiment of the disclosure, wherein the sample is an intestinal microbiota, optionally obtained from faeces of a test subject. The intestinal microbiota is obtained from fecal samples of ACVD patients, which is low cost, safe and has no side effects. Fecal analysis can ensure accuracy, safety, affordability, and patient compliance. And the fecal sample is transportable. Specific biomarkers can be used as non-invasive tests for early diagnosis of patients suffering from ACVD, thereby extending survival and improving quality of life.
According to embodiments of the present disclosure, the above-described method may be implemented as follows: (1) Determining the relative abundance of the biomarker in a sample of the test subject; (2) Comparing the relative abundance information of the biomarkers in the subject sample to a training dataset by using a multivariate statistical model, thereby obtaining a probability of atherosclerotic cardiovascular disease; wherein a probability of the atherosclerotic cardiovascular disease being greater than a threshold value indicates that the subject being tested has or is at risk of developing an atherosclerotic cardiovascular disease or associated condition thereof. A training dataset is constructed based on the relative abundance information of each biomarker for a plurality of subjects with ACVD and a plurality of normal subjects using a multivariate statistical model, optionally the multivariate statistical model is a random forest model. The training dataset is a matrix, each row represents each biomarker of the biomarker set described above, each column represents a sample, each cell represents a plot of the relative abundance of the biomarker in the sample, the sample disease state is a vector, 1 is ACVD, and 0 is a control. The relative abundance information for each of SEQ ID NOs 1, 2 and 3 is the relative abundance information shown in table 4. A probability of ACVD of at least 0.5 indicates that the subject being tested has or is at risk of developing ACVD or a related disorder.
Kit for predicting ACVD risk
Embodiments of the fourth broad aspect of the present disclosure provide a kit for predicting the risk of an atherosclerotic cardiovascular disease or associated condition thereof. According to an embodiment of the invention, a kit comprises: a reagent configured to detect the biomarker. The kit finds use in effectively and easily predicting the risk of atherosclerotic cardiovascular disease or a related condition thereof.
According to an embodiment of the present disclosure, wherein the reagent comprises at least one of a probe, a primer, a gene chip, and an antibody. Probes, gene chips and antibodies specifically recognize the above biomarkers, and primers specifically amplify the above biomarkers based on Polymerase Chain Reaction (PCR) assays. The kit is comfortable and non-invasive compared to invasive coronary angiography, so one can more easily participate in a given screening procedure.
It is believed that the 3 ACVD-related gene markers of the intestinal microbiota are of great value for enhancing the early discovery of metabolic diseases for the following reasons. First, the markers of the present invention are more specific and sensitive than conventional markers. Second, stool analysis can ensure accuracy, safety, affordability, and patient compliance. And the fecal sample is transportable. Polymerase Chain Reaction (PCR) based detection methods are both comfortable and non-invasive compared to invasive coronary angiography, and therefore one would be more likely to participate in a given screening procedure. Third, the markers of the invention can also be used as tools for therapy monitoring of ACVD patients to detect response to therapy.
Examples
Identification of 3 biomarkers to assess risk of ACVD
Sample collection
Samples of 405 subjects, including 218 individuals with ACVD and 187 control subjects, were collected at the general hospital medical study center in guangdong province. Individuals with ACVD showed clinical manifestations of stable angina, unstable angina or Acute Myocardial Infarction (AMI) (table 1). ACVD diagnosis was confirmed by coronary angiography and individuals with > 50% stenosis in single or multiple vessels were accepted. All patients were chinese han nationality, had no blood relationship, and were between 40 and 80 years of age. Exclusion criteria included persistent infectious disease, cancer, renal or hepatic failure, peripheral neuropathy, stroke, and antibiotic usage within one month of sample collection. At physical examination, no clinically significant ACVD symptoms were present in all enrolled healthy control individuals. Demographic data and cardiovascular risk factors are collected by questionnaires. Individuals with peripheral arterial disease, known coronary artery disease or myocardial infarction, cardiomyopathy, renal failure, peripheral neuropathy, systemic disease, and stroke are excluded. Fresh feces from each subject were collected the first morning after admission and frozen on dry ice for 30 minutes, stored in a-80 ℃ freezer, and then further analyzed.
The study was approved by the ethical review Committee of general Hospital medicine, guangdong province and the ethical review Committee of Shenzhen Daliving science, inc. Informed consent was obtained from all participants.
Table 1: baseline characteristics of ACVD cases and controls. Both age and BMI were tested by Wilcoxon rank sum test, while gender was tested by Fisher test.
Parameters (parameters) Case (n=218) Case NA Control (n=187) Control NA P value
Age of 60.8 0 60.2 7 0.094
Sex (M: F) 161:53 4 75:111 1 1.263e-12
BMI 24.54 67 24.41 7 0.0289
Note that: the third and fifth columns are the number of subjects who do not know age, gender, or BMI information.
Extraction of DNA from fecal samples
Fecal samples were thawed on ice and DNA extracted using Qiagen QIAamp DNA Stool Mini Kit (Qiagen) according to manufacturer's instructions. The extract was treated with DNase-free RNase to eliminate RNA contamination. The amount of DNA was determined using a NanoDrop spectrophotometer, qubit Fluorometer (with Quant-iTTM dsDNA BR assay kit) and gel electrophoresis.
DNA library construction and sequencing of fecal samples
The construction of the DNA library was performed according to the manufacturer's instructions (Illumina). We used the same workflow 5 as described previously to perform cluster generation, template hybridization, isothermal amplification, linearization, blocking and denaturation, hybridization of sequencing primers. We constructed a double-ended (PE) library with insert sizes of 350bp for each sample, followed by high-throughput sequencing to obtain about 3000 ten thousand PE reads of 2x100bp in length. Low quality reads with indeterminate "N" bases, linker contamination and human DNA contamination are filtered from Illumina original reads, and high quality reads are obtained by simultaneously trimming the terminal bases of the low quality reads.
Metagenomic data processing and analysis
Construction of a genetic map. Using a standard with identity > 90%, high quality reads were aligned with 9,879,896 genes (9.9M gene set) by SOAP 2. Sequencing-based gene abundance patterns were performed as previously described (Li, J. Et al An integrated catalog of reference genes in the human gut Microbiol. Nat. Biotechnol.32,834-841 (2014), incorporated herein by reference).
Genes identified by MGWAS that are associated with ACVD. After filtering 9,879,896 genes at an incidence rate in more than 10 samples, the inventors identified potential biomarkers of ACVD from the remaining genes by MGWAS method using minimum redundancy maximum correlation (mRMR) feature selection method (H.Peng, F.Long, C.Ding, feature selection based on mutual information: criterion of max-dependency, max-reduction, and min-reduction, ieee transactions on pattern analysis and machine intelligence 27,1226, 8 months 2005, incorporated herein by reference), and they selected the first 500 most powerful whole genes.
They rank the 500 genes by training set cross-validation, test set ROC and prediction error, and finally select the 3 best genes (tables 2 and 3).
Considering AUC and estimated error rate for all 405 samples (see table 5 and table 6), the inventors selected the 3 most discriminatory genes consisting of genes 3050214, 2841974, 6560409 (see table 3).
The inventors tested the ability to isolate ACVD patients and controls using these 3 genes as biomarkers, respectively: they randomly split 405 samples into a training set (70% of 405 samples) and a test set (30% of 405 samples), then calculate the estimated error rate and AUC for each biomarker in the training set by cross-validation, and calculate the estimated error and AUC for each biomarker in the test set by a module built from the training set (tables 4, 5 and 6).
In addition, the inventors calculated the expected error rate and AUC from the 3 combined gene sets on the training and test sets (table 7), found that AUC for the training set was 0.796, AUC for the test set was 0.761, error rate in the training set was 0.278, and error rate in the test set was 0.322.
Table 2: the 3 most discriminating genes associated with ACVD
(enrichment sample: 1: ACVD,0: control)
Table 3: sequence numbers of 3 Gene markers
Gene numbering SEQ ID NO Base factor (Length) 9.9M Gene name in Gene set
3050214 1 861 N056A_GL0000096
2841974 2 900 ED9A_GL0080283
6560409 3 402 NLM027_GL0004265
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Table 5 probability of ACVD calculated from 3 genes on each of 405 samples (enriched samples: 1: ACVD;0: control, if probability. Gtoreq.0.5, subject at risk of ACVD) respectively
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Table 6: the probability of ACVD calculated from each of the 3 genes on 405 samples (70% of 405 samples are training sets and 30% of 405 samples are test sets)
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Table 7: the probability of ACVD calculated by 3 genome aggregation on 405 samples (70% of 405 samples are training sets and 30% of 405 samples are test sets)
In addition, terms such as "first" and "second" are used herein for descriptive purposes and not to indicate or imply relative importance or significance.
Reference in the specification to "an embodiment," "some embodiments," "one embodiment," "another example," "an example," "a particular example," or "some examples" means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the present disclosure. Thus, phrases such as "in some embodiments," "in one embodiment," "in an embodiment," "in another example," "in an example," "in a particular example," or "in certain examples" appearing in various places throughout the specification are not necessarily referring to the same implementation or example of the disclosure. Furthermore, the particular features, structures, materials, or characteristics may be combined in any suitable manner in one or more embodiments or examples.
Although illustrative embodiments have been shown and described, it will be understood by those skilled in the art that the above embodiments are not to be construed as limiting the present disclosure and that changes, substitutions and modifications may be made to the embodiments without departing from the spirit, principles and scope of the disclosure.
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acccgcgcca agaagtccat cgcgcagttc aagctgcgtg agggccaggc gatcggtgcg 120
cacgtcacgc ttcgcggcga ccgcatgtgg gagttcctgg atcgcctcct ctcgacggcg 180
cttccccgta tccgtgactt ccgcggactg tcctccaagc agttcgacgg tcacggcaat 240
tacaccttcg gtctcacgga acagtcgatg ttccacgaga tcgatcagga ctcgatcgac 300
cgagtgcgcg gcatggacat cacggttgtc acctcggcca ccaccgacga agagggtcgc 360
gcccttctcc gtcacctcgg cttcccgttc aaggaggact ga 402

Claims (7)

1. A biomarker for atherosclerotic cardiovascular disease, said biomarker being SEQ ID NO: 1-3.
2. The use of a reagent for detecting the abundance of a biomarker for an atherosclerotic cardiovascular disease in the preparation of a kit for predicting whether a sample is a sample of an atherosclerotic cardiovascular disease,
the sample is a fecal sample, and the biomarker is SEQ ID NO: 1-3.
3. The use according to claim 2, comprising predicting whether the sample is a sample of an atherosclerotic cardiovascular disease by:
(1) Determining the relative abundance of the biomarker of claim 2 in the sample; and
(2) Predicting whether the sample is a sample of an atherosclerotic cardiovascular disease based on the relative abundance of the biomarker of claim 2.
4. The use of claim 3, wherein step (2) comprises comparing the relative abundance of the biomarker to a preset threshold.
5. The use of claim 4, wherein the preset threshold is obtained based on a plurality of control samples having a known condition of atherosclerotic cardiovascular disease.
6. The use of claim 5, wherein the preset threshold is at least 0.5.
7. The use of claim 3, wherein the relative abundance of the biomarker is obtained by sequencing.
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