Acute and chronic coronary syndromes (ACS and CCS) are leading causes of mortality. Inflammation is considered a key pathogenic driver of these diseases, but the underlying immune states and their clinical implications remain poorly understood. Multiomic factor analysis (MOFA) allows unsupervised data exploration across multiple data types, identifying major axes of variation and associating these with underlying molecular processes. We hypothesized that applying MOFA to multiomic data obtained from blood might uncover hidden sources of variance and provide pathophysiological insights linked to clinical needs. Here we compile a longitudinal multiomic dataset of the systemic immune landscape in both ACS and CCS (n = 62 patients in total, n = 15 women and n = 47 men) and validate this in an external cohort (n = 55 patients in total, n = 11 women and n = 44 men). MOFA reveals multicellular immune signatures characterized by distinct monocyte, natural killer and T cell substates and immune-communication pathways that explain a large proportion of inter-patient variance. We also identify specific factors that reflect disease state or associate with treatment outcome in ACS as measured using left ventricular ejection fraction. Hence, this study provides proof-of-concept evidence for the ability of MOFA to uncover multicellular immune programs in cardiovascular disease, opening new directions for mechanistic, biomarker and therapeutic studies.
GrantsChan Zuckerberg Foundation German Cancer Aid Else Kroner-Fresenius-Stiftung European Union Melanoma Research Alliance International doctoral program 'i-Target: immunotargeting of cancer' - Elite Network of Bavaria TANGO Bavarian Cancer Research Center (BZKF) German Centre for Cardiovascular Research (DZHK) ERC Corona Foundation DFG Deutsche Forschungsgemeinschaft (DFG) Deutsche Herzstiftung e.V. DZHK partner site project Wilhelm-Sander-Stiftung Ernst Jung Stiftung ERC Advanced Grant under the European Union Zuckerberg Foundation Helmholtz Association Forderprogramm fur Forschung und Lehre (FoeFoLe) of LMU Munich Bavarian Research Foundation Ernst und Berta Grimmke Stiftung Hector Foundation Fritz-Bender Foundation PoC European Research Council Bundesministerium fur Bildung und Forschung Bavarian Ministry for Economical Affairs Institutional Strategy LMUexcellent of LMU Munich Deutsche Forschungsgemeinschaft (German Research Foundation)