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Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome
Objective: Trimethylamine N-oxide (TMAO), a pathological microbial metabolite, is demonstrated to be related to cardiovascular diseases. This study was (1) to investigate the association between TMAO and aortic stenosis and (2) to determine the prognostic value of TMAO for predicting mortality after...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861904/ https://www.ncbi.nlm.nih.gov/pubmed/36675336 http://dx.doi.org/10.3390/jcm12020407 |
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author | Guo, Yuchao Xu, Shaojun Zhan, Hong Chen, Han Hu, Po Zhou, Dao Dai, Hanyi Liu, Xianbao Hu, Wangxing Zhu, Gangjie Suzuki, Toru Wang, Jian’an |
author_facet | Guo, Yuchao Xu, Shaojun Zhan, Hong Chen, Han Hu, Po Zhou, Dao Dai, Hanyi Liu, Xianbao Hu, Wangxing Zhu, Gangjie Suzuki, Toru Wang, Jian’an |
author_sort | Guo, Yuchao |
collection | PubMed |
description | Objective: Trimethylamine N-oxide (TMAO), a pathological microbial metabolite, is demonstrated to be related to cardiovascular diseases. This study was (1) to investigate the association between TMAO and aortic stenosis and (2) to determine the prognostic value of TMAO for predicting mortality after transcatheter aortic valve replacement (TAVR). Methods: 299 consecutive patients (77 (72–81) years, 58.2% male, Society of Thoracic Surgeons (STS) score 5.8 (4.9–9.3)) with severe aortic stenosis and 711 patients (59 (52–66) years, 51.9% male) without aortic stenosis were included in this retrospective study. A total of 126 pairs of patients were assembled by Propensity Score Matching. The primary outcome was all-cause mortality using survival analyses stratified by TMAO quartiles. Results: Patients with severe aortic stenosis had higher TMAO levels (3.18 (1.77–6.91) μmol/L vs. 1.78 (1.14–2.68) μmol/L, p < 0.001), and TMAO remained significantly higher after adjusting for baseline characteristics. Higher TMAO level was associated with higher 2-year all-cause mortality (19.2% vs. 9.5%, log-rank p = 0.028) and higher late cumulative mortality (34.2% vs. 19.1%, log-rank p = 0.004). In Cox regression multivariate analysis, higher TMAO level remained an independent predictor (hazard ratio 1.788; 95% CI 1.064–3.005, p = 0.028) of all-cause mortality after adjusting for STS score, N-terminal pro b-type natriuretic peptide, and maximum velocity. Conclusions: The TMAO level was higher in aortic stenosis patients. Elevated TMAO was associated with poor adverse outcome after TAVR. |
format | Online Article Text |
id | pubmed-9861904 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98619042023-01-22 Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome Guo, Yuchao Xu, Shaojun Zhan, Hong Chen, Han Hu, Po Zhou, Dao Dai, Hanyi Liu, Xianbao Hu, Wangxing Zhu, Gangjie Suzuki, Toru Wang, Jian’an J Clin Med Article Objective: Trimethylamine N-oxide (TMAO), a pathological microbial metabolite, is demonstrated to be related to cardiovascular diseases. This study was (1) to investigate the association between TMAO and aortic stenosis and (2) to determine the prognostic value of TMAO for predicting mortality after transcatheter aortic valve replacement (TAVR). Methods: 299 consecutive patients (77 (72–81) years, 58.2% male, Society of Thoracic Surgeons (STS) score 5.8 (4.9–9.3)) with severe aortic stenosis and 711 patients (59 (52–66) years, 51.9% male) without aortic stenosis were included in this retrospective study. A total of 126 pairs of patients were assembled by Propensity Score Matching. The primary outcome was all-cause mortality using survival analyses stratified by TMAO quartiles. Results: Patients with severe aortic stenosis had higher TMAO levels (3.18 (1.77–6.91) μmol/L vs. 1.78 (1.14–2.68) μmol/L, p < 0.001), and TMAO remained significantly higher after adjusting for baseline characteristics. Higher TMAO level was associated with higher 2-year all-cause mortality (19.2% vs. 9.5%, log-rank p = 0.028) and higher late cumulative mortality (34.2% vs. 19.1%, log-rank p = 0.004). In Cox regression multivariate analysis, higher TMAO level remained an independent predictor (hazard ratio 1.788; 95% CI 1.064–3.005, p = 0.028) of all-cause mortality after adjusting for STS score, N-terminal pro b-type natriuretic peptide, and maximum velocity. Conclusions: The TMAO level was higher in aortic stenosis patients. Elevated TMAO was associated with poor adverse outcome after TAVR. MDPI 2023-01-04 /pmc/articles/PMC9861904/ /pubmed/36675336 http://dx.doi.org/10.3390/jcm12020407 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Guo, Yuchao Xu, Shaojun Zhan, Hong Chen, Han Hu, Po Zhou, Dao Dai, Hanyi Liu, Xianbao Hu, Wangxing Zhu, Gangjie Suzuki, Toru Wang, Jian’an Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome |
title | Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome |
title_full | Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome |
title_fullStr | Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome |
title_full_unstemmed | Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome |
title_short | Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome |
title_sort | trimethylamine n-oxide levels are associated with severe aortic stenosis and predict long-term adverse outcome |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861904/ https://www.ncbi.nlm.nih.gov/pubmed/36675336 http://dx.doi.org/10.3390/jcm12020407 |
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