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Acute coronary syndromes

Microbial-dependent TMAO as a prognostic marker in ACS

Nature Reviews Cardiology volume 14, pages 128–129 (2017)Cite this article

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In a single-centre, prospective, US cohort of 530 individuals presenting with chest pain of suspected cardiac origin, high plasma TMAO levels at presentation independently predicted the risk of major adverse cardiovascular events (MACE; a composite of myocardial infarction, stroke, revascularization, or all-cause death) at 30 days (4th quartile (Q4) adjusted OR 6.30, 95% CI 1.89–21.0, P <0.01) and 6 months (Q4 adjusted OR 5.65, 95% CI 1.91–16.7, P <0.01) of follow-up, even in those individuals without elevated troponin T levels at baseline. TMAO levels also independently predicted long-term (7-year) mortality. In an independent, multicentre, Swiss cohort of 1,683 patients with ACS who underwent coronary angiography, high TMAO levels were also a predictor of risk of MACE at 1 year (Q4 adjusted HR 1.57, 95% CI 1.03–2.41, P <0.05).

This study underscores the interest in developing therapeutic approaches to target this pathway

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References

  1. Li, X. S. et al. Gut microbiota-dependent trimethylamine N-oxide in acute coronary syndromes: a prognostic marker for incident cardiovascular events beyond traditional risk factors. Eur. Heart J. http://dx.doi.org/10.1093/eurheartj/ehw582 (2017)

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Authors
  1. Irene Fernández-Ruiz
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Jonsson,A.L.&Bäckhed,F.Roleofgutmicrobiotainatherosclerosis.Nat.Rev.Cardiol.http://dx.doi.org/10.1038/nrcardio.2016.183(2016)

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Fernández-Ruiz, I. Microbial-dependent TMAO as a prognostic marker in ACS. Nat Rev Cardiol 14, 128–129 (2017). https://doi.org/10.1038/nrcardio.2017.10

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  • DOI: https://doi.org/10.1038/nrcardio.2017.10

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