Trimethylamine-N-oxide Has Prognostic Value in Coronary Heart Disease: a Meta-analysis and Dose-response Analysis

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2020 Jan 11

PMID 31918665

Citations 44

Authors

Miao-En Yao

Peng-Da Liao

Xu-Jie Zhao

Lei Wang

Affiliations

Soon will be listed here.

Abstract

Background: Previous clinical studies have suggested that trimethylamine-N-oxide (TMAO) could contribute to the development of atherosclerosis cardiovascular disease. However, the synthetic analysis in coronary heart disease (CHD) was not yet performed. We aimed to clarify the relationship between elevated plasma concentrations of TMAO and the incidence of major adverse cardiovascular events (MACE) in CHD patients.

Methods: Meta-analysis and dose-response analysis of hazard ratio data from prospective observational studies reporting on the association between TMAO plasma concentrations and the incidence of MACE in patients with CHD were conducted.

Results: Of the 2369 published articles identified in the search, seven papers, with data from nine cohort studies (10,301 patients), were included in the meta-analysis. Combined data showed that elevated plasma TMAO concentrations could increase 58% higher risk of MACE in patients with CHD (hazard ratios [HR]: 1.58; 95% confidence interval [CI] = 1.35-1.84, P = 0.000). For follow-up ≥ 1 year, it was associated with 62% higher risk of MACE in patients with longer-term than shorter-term (HR for follow-up ≥ 4 years: 1.96; 95% CI = 1.52-2.52 vs one to 3 years: 1.34; 95% CI = 1.26-1.43, P = 0.004). The dose-response analysis revealed a 'J' shaped association between TMAO concentration and the incidence of MACE (P = 0.033), with the concentration above 5.1 μmol/L being associated with HR of > 1.

Conclusions: Elevated levels of TMAO are associated with an increased incidence of MACE in patients with CHD. TMAO concentration of 5.1 μmol/L may be a cut-off value for prognosis.

Citing Articles

Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis.

Li X, Wang Y, Xu J, Luo K, Dong T Front Cardiovasc Med. 2024; 11:1334730.

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The Role of Microbiome in Cardiovascular Health: Insights for Primary Care Interventions.

Arvelaez Pascucci J, Ghattas P, Olivas Lerma R, Nogueyra S, Nogales Bernal M, Milani V Cureus. 2024; 16(9):e70311.

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Gut Microbiota and Metabolic Alterations Associated with Heart Failure and Coronary Artery Disease.

Yafarova A, Dementeva E, Zlobovskaya O, Sheptulina A, Lopatukhina E, Timofeev Y Int J Mol Sci. 2024; 25(20).

PMID: 39457077 PMC: 11508380. DOI: 10.3390/ijms252011295.

Association between plasma trimethylamine N-oxide and coronary heart disease: new insights on sex and age differences.

Sun Y, Lin X, Liu Z, Hu L, Sun P, Shen G Front Cardiovasc Med. 2024; 11:1397023.

PMID: 39434851 PMC: 11491342. DOI: 10.3389/fcvm.2024.1397023.

The association between the gut microbiota metabolite trimethylamine N-oxide and heart failure.

Jarmukhanov Z, Mukhanbetzhanov N, Kozhakhmetov S, Nurgaziyev M, Sailybayeva A, Bekbossynova M Front Microbiol. 2024; 15:1440241.

PMID: 39391607 PMC: 11464299. DOI: 10.3389/fmicb.2024.1440241.

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