Frontiers in Endocrinology (Jul 2024)

Trimethylamine N-oxide predicts cardiovascular events in coronary artery disease patients with diabetes mellitus: a prospective cohort study

  • Xue Yu,
  • Xue Yu,
  • Yijia Wang,
  • Ruiyue Yang,
  • Zhe Wang,
  • Xinyue Wang,
  • Siming Wang,
  • Wenduo Zhang,
  • Jun Dong,
  • Wenxiang Chen,
  • Fusui Ji,
  • Wei Gao,
  • Wei Gao

DOI
https://doi.org/10.3389/fendo.2024.1360861
Journal volume & issue
Vol. 15

Abstract

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BackgroundGut microbiota has significant impact on the cardio-metabolism and inflammation, and is implicated in the pathogenesis and progression of atherosclerosis. However, the long-term prospective association between trimethylamine N-oxide (TMAO) level and major adverse clinical events (MACEs) in patients with coronary artery disease (CAD) with or without diabetes mellitus (DM) habitus remains to be investigated.MethodsThis prospective, single-center cohort study enrolled 2090 hospitalized CAD patients confirmed by angiography at Beijing Hospital from 2017-2020. TMAO levels were performed using liquid chromatography-tandem mass spectrometry. The composite outcome of MACEs was identified by clinic visits or interviews annually. Multivariate Cox regression analysis, Kaplan-Meier analysis, and restricted cubic splines were mainly used to explore the relationship between TMAO levels and MACEs based on diabetes mellitus (DM) habitus.ResultsDuring the median follow-up period of 54 (41, 68) months, 266 (12.7%) developed MACEs. Higher TMAO levels, using the tertile cut-off value of 318.28 ng/mL, were significantly found to be positive dose-independent for developing MACEs, especially in patients with DM (HR 1.744, 95%CI 1.084-2.808, p = 0.022).ConclusionsHigher levels of TMAO are significantly associated with long-term MACEs among CAD patients with DM. The combination of TMAO in patients with CAD and DM is beneficial for risk stratification and prognosis.

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