eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2023
vol. 19
 
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abstract:
Original paper

Plasma concentration of TMAO is an independent predictor of adverse outcomes in patients after acute myocardial infarction

Aleksandra Gąsecka
1
,
Oliwia Fidali
1
,
Aleksandra Kłębukowska
1
,
Karolina Jasińska-Gniadzik
1
,
Piotr Szwed
1
,
Karolina Witkowska
2
,
Ceren Eyileten
2
,
Marek Postuła
2
,
Marcin Grabowski
1
,
Krzysztof J. Filipiak
3
,
Marcin Ufnal
4

  1. Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
  2. Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, Warsaw, Poland 
  3. Department of Experimental Physiology and Pathophysiology, Centre for Preclinical Research and Technology, Medical University of Warsaw, Warsaw, Poland 
  4. Department of Clinical Sciences, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
Adv Interv Cardiol 2023; 19, 1 (71): 31–39
DOI: https://doi.org/10.5114/aic.2022.123884
Online publish date: 2023/01/23
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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:
he 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:
ncreased plasma concentration of TMAO is an independent predictor of MACCE and may contribute to post-AMI cardiac dysfunction. 

keywords:

acute myocardial infarction, major adverse cardiovascular events, gut microbiome, gut metabolites, TMAO, prognosis
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