Articles producció científica> Medicina i Cirurgia

Plasma trimethylamine-N-oxide, its precursors and risk of cardiovascular events in patients with acute coronary syndrome: Mediating effects of renal function

  • Identification data

    Identifier: imarina:9282774
    Authors:
    Sanchez-Gimenez, RaulPeiro, Oscar MBonet, GilCarrasquer, AnnaFragkiadakis, Georgios ABullo, MonicaPapandreou, ChristopherBardaji, Alfredo
    Abstract:
    AimsTo examine associations of the gut microbial metabolite trimethylamine-N-oxide (TMAO) and its precursors with risk of cardiovascular events in acute coronary syndrome (ACS), and determine whether these associations were mediated by renal function. MethodsIn this prospective cohort study, we included 309 patients with ACS. During a mean follow-up of 6.7 years, 131 patients developed major adverse cardiovascular events (MACE) (myocardial infarction, hospitalization for heart failure, and all-cause mortality). Plasma concentrations of TMAO, trimethylamine (TMA), choline, betaine, dimethylglycine and L-carnitine were profiled by liquid chromatography tandem mass spectrometry. Hazard ratios were estimated with multivariable Cox regression models. The mediating role of estimated glomerular filtration rate (eGFR) was tested under a counterfactual framework. ResultsAfter adjustment for traditional cardiovascular risk factors and medications, participants in the highest tertile vs. the lowest tertile of baseline TMAO and dimethylglycine concentrations had a higher risk of MACE [(HR: 1.83; 95% CI: 1.08, 3.09) and (HR: 2.26; 95% CI: 1.17, 3.99), respectively]. However, with regards to TMAO these associations were no longer significant, whereas for dimethylglycine, the associations were attenuated after additional adjustment for eGFR. eGFR mediated the associations of TMAO (58%) and dimethylglycine (32%) with MACE incidence. The associations between dimethylglycine and incident MACE were confirmed in an internal validation. No significant associations were found for TMA, choline, betaine and L-carnitine. ConclusionThese findings suggest that renal function may be a key mediator in the association of plasma TMAO with the development of cardiovascular events after ACS. The presen
  • Others:

    Author, as appears in the article.: Sanchez-Gimenez, Raul; Peiro, Oscar M; Bonet, Gil; Carrasquer, Anna; Fragkiadakis, Georgios A; Bullo, Monica; Papandreou, Christopher; Bardaji, Alfredo
    Department: Bioquímica i Biotecnologia Medicina i Cirurgia
    URV's Author/s: Bardají Ruiz, Alfredo / Bonet Pineda, Gil / Bulló Bonet, Mònica
    Keywords: Trimethylamine-n-oxide Prognostic Myocardial-infarction Mortality Models Methyltransferase Metabolites Marker Major adverse cardiovascular events Dimethylglycine Choline Acute coronary syndrome
    Abstract: AimsTo examine associations of the gut microbial metabolite trimethylamine-N-oxide (TMAO) and its precursors with risk of cardiovascular events in acute coronary syndrome (ACS), and determine whether these associations were mediated by renal function. MethodsIn this prospective cohort study, we included 309 patients with ACS. During a mean follow-up of 6.7 years, 131 patients developed major adverse cardiovascular events (MACE) (myocardial infarction, hospitalization for heart failure, and all-cause mortality). Plasma concentrations of TMAO, trimethylamine (TMA), choline, betaine, dimethylglycine and L-carnitine were profiled by liquid chromatography tandem mass spectrometry. Hazard ratios were estimated with multivariable Cox regression models. The mediating role of estimated glomerular filtration rate (eGFR) was tested under a counterfactual framework. ResultsAfter adjustment for traditional cardiovascular risk factors and medications, participants in the highest tertile vs. the lowest tertile of baseline TMAO and dimethylglycine concentrations had a higher risk of MACE [(HR: 1.83; 95% CI: 1.08, 3.09) and (HR: 2.26; 95% CI: 1.17, 3.99), respectively]. However, with regards to TMAO these associations were no longer significant, whereas for dimethylglycine, the associations were attenuated after additional adjustment for eGFR. eGFR mediated the associations of TMAO (58%) and dimethylglycine (32%) with MACE incidence. The associations between dimethylglycine and incident MACE were confirmed in an internal validation. No significant associations were found for TMA, choline, betaine and L-carnitine. ConclusionThese findings suggest that renal function may be a key mediator in the association of plasma TMAO with the development of cardiovascular events after ACS. The present findings also support a role of dimethylglycine in the pathogenesis of MACE, which may be mediated, at least partially, by renal function.
    Thematic Areas: Cardiology and cardiovascular medicine Cardiac & cardiovascular systems
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: gil.bonet@urv.cat monica.bullo@urv.cat alfredo.bardaji@urv.cat
    Author identifier: 0000-0002-0218-7046 0000-0003-1900-6974
    Record's date: 2024-10-12
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://www.frontiersin.org/articles/10.3389/fcvm.2022.1000815/full
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Front Cardiovasc Med. 9 1000815-
    APA: Sanchez-Gimenez, Raul; Peiro, Oscar M; Bonet, Gil; Carrasquer, Anna; Fragkiadakis, Georgios A; Bullo, Monica; Papandreou, Christopher; Bardaji, Alfred (2022). Plasma trimethylamine-N-oxide, its precursors and risk of cardiovascular events in patients with acute coronary syndrome: Mediating effects of renal function. Front Cardiovasc Med, 9(), 1000815-. DOI: 10.3389/fcvm.2022.1000815
    Article's DOI: 10.3389/fcvm.2022.1000815
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2022
    Publication Type: Journal Publications
  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine
    Trimethylamine-n-oxide
    Prognostic
    Myocardial-infarction
    Mortality
    Models
    Methyltransferase
    Metabolites
    Marker
    Major adverse cardiovascular events
    Dimethylglycine
    Choline
    Acute coronary syndrome
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
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