TY - JOUR
T1 - Plasma concentration of TMAO is an independent predictor of adverse outcomes in patients after acute myocardial infarction
AU - Gąsecka, Aleksandra
AU - Fidali, Oliwia
AU - Kłębukowska, Aleksandra
AU - Jasińska-Gniadzik, Karolina
AU - Szwed, Piotr
AU - Witkowska, Karolina
AU - Eyileten, Ceren
AU - Postuła, Marek
AU - Grabowski, Marcin
AU - Filipiak, Krzysztof J.
AU - Ufnal, Marcin
N1 - Funding Information: The study was funded by the National Science Centre, Poland, grant no. 2020/37/B/NZ5/00366. Publisher Copyright: © 2023 Termedia Publishing House Ltd.. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Introduction: Plasma concentrations of gut microbial metabolites are associated with cardiomyocyte viability and platelet reactivity. We hypothesized that increased concentrations of gut metabolites may predict major adverse cardiac and cerebrovascular events (MACCE) after acute myocardial infarction (AMI). Aim: The primary objective of this study was to evaluate the association between elevated plasma concentrations of gut metabolites and MACCE after AMI. Material and methods: We compared plasma concentrations of gut metabolites (trimethylamine-N-oxide (TMAO) and indoxyl sulphate (IS)) and platelet reactivity in 57 patients with AMI and 27 healthy controls. We assessed the predictive value of gut metabolites for MACCE (stroke, recurrent AMI, death) over a median of 3.5-years. Results: The concentrations of TMAO and IS did not differ between AMI patients and controls. The concentrations of TMAO and IS were higher in patients who developed MACCE than in those who did not (p ≤ 0.015 for all). The concentration of TMAO was the only independent predictor of MACCE in a multivariate analysis (OR = 35.041, 95% CI: 1.269–967.307, p = 0.036). Patients with the concentration of TMAO and indoxyl sulphate above the cut-off value predictive of MACCE had higher platelet activity (p ≤ 0.149 for all). Conclusions: Increased plasma concentration of TMAO is an independent predictor of MACCE and may contribute to post-AMI cardiac dysfunction.
AB - Introduction: Plasma concentrations of gut microbial metabolites are associated with cardiomyocyte viability and platelet reactivity. We hypothesized that increased concentrations of gut metabolites may predict major adverse cardiac and cerebrovascular events (MACCE) after acute myocardial infarction (AMI). Aim: The primary objective of this study was to evaluate the association between elevated plasma concentrations of gut metabolites and MACCE after AMI. Material and methods: We compared plasma concentrations of gut metabolites (trimethylamine-N-oxide (TMAO) and indoxyl sulphate (IS)) and platelet reactivity in 57 patients with AMI and 27 healthy controls. We assessed the predictive value of gut metabolites for MACCE (stroke, recurrent AMI, death) over a median of 3.5-years. Results: The concentrations of TMAO and IS did not differ between AMI patients and controls. The concentrations of TMAO and IS were higher in patients who developed MACCE than in those who did not (p ≤ 0.015 for all). The concentration of TMAO was the only independent predictor of MACCE in a multivariate analysis (OR = 35.041, 95% CI: 1.269–967.307, p = 0.036). Patients with the concentration of TMAO and indoxyl sulphate above the cut-off value predictive of MACCE had higher platelet activity (p ≤ 0.149 for all). Conclusions: Increased plasma concentration of TMAO is an independent predictor of MACCE and may contribute to post-AMI cardiac dysfunction.
KW - TMAO
KW - acute myocardial infarction
KW - gut metabolites
KW - gut microbiome
KW - major adverse cardiovascular events
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85158154468&partnerID=8YFLogxK
U2 - https://doi.org/10.5114/aic.2022.123884
DO - https://doi.org/10.5114/aic.2022.123884
M3 - Article
C2 - 37090218
SN - 1734-9338
VL - 19
SP - 31
EP - 39
JO - Postepy w Kardiologii Interwencyjnej
JF - Postepy w Kardiologii Interwencyjnej
IS - 1
ER -