Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis

BackgroundTrimethylamine N-oxide (TMAO) has been widely explored and considered as a biomarker for adverse cardiovascular events. However, the relationships between TMAO adverse cardiovascular events are inconsistent in patients. Therefore, this meta-analysis aimed to estimate association between TM...

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Main Authors: Xiuqing Li, Yubao Wang, Jie Xu, Kaili Luo, Tao Dong
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2024.1334730/full
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author Xiuqing Li
Yubao Wang
Jie Xu
Kaili Luo
Tao Dong
author_facet Xiuqing Li
Yubao Wang
Jie Xu
Kaili Luo
Tao Dong
author_sort Xiuqing Li
collection DOAJ
description BackgroundTrimethylamine N-oxide (TMAO) has been widely explored and considered as a biomarker for adverse cardiovascular events. However, the relationships between TMAO adverse cardiovascular events are inconsistent in patients. Therefore, this meta-analysis aimed to estimate association between TMAO levels and the prognosis of patients with myocardial infarction (MI).MethodsWe searched PubMed, EMBASE, the Cochrane Library, and Web of Science from inception to July 2, 2023, to retrieve all relevant clinical trials. Associations between TMAO levels, major adverse cardiovascular events (MACE), all-cause mortality, recurrent MI, stroke, etc., were systematically addressed. Outcomes included MACE, all-cause mortality, recurrent MI, rehospitalization caused by heart failure, stroke, revascularization, SYNTAX score, and multivessel disease. A fixed/random-effects model should be adopted to calculate the pooled estimates. Besides, funnel plot, Begg's test and Egger' test were used to test publication bias.ResultsA total of nine studies were included in our meta-analysis. Our results indicated that higher TMAO levels were associated with greater risk of MACE (RR = 1.94; 95% CI = 1.39 to 2.73), all-cause mortality (RR = 1.56; 95% CI = 1.00 to 2.44), and MI (RR = 1.21; 95% CI = 1.01 to 1.45). No significant association was found in stroke, SYNTAX, and multivessel disease. Besides, our results reported that the association between TMAO levels and MACE after MI was not affected by the geographic localization.ConclusionThis study was the first meta-analysis that showed a significant positive association of TMAO levels with MACE, all-cause mortality, and recurrent MI in patients with MI.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=460400, PROSPERO (CRD42023460400).
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spelling doaj-art-dabd7b5a569146b1aaf4931fdd09deb42025-08-20T02:22:06ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-12-011110.3389/fcvm.2024.13347301334730Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysisXiuqing Li0Yubao Wang1Jie Xu2Kaili Luo3Tao Dong4Department of Gastroenterology and Hepatology, The Third People’s Hospital of Zhenjiang, Zhenjiang, Jiangsu, ChinaDepartment of Cardiology, The Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Cardiology, The Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, ChinaDepartment of Gastroenterology and Hepatology, The Third People’s Hospital of Zhenjiang, Zhenjiang, Jiangsu, ChinaDepartment of Gastroenterology and Hepatology, The Third People’s Hospital of Zhenjiang, Zhenjiang, Jiangsu, ChinaBackgroundTrimethylamine N-oxide (TMAO) has been widely explored and considered as a biomarker for adverse cardiovascular events. However, the relationships between TMAO adverse cardiovascular events are inconsistent in patients. Therefore, this meta-analysis aimed to estimate association between TMAO levels and the prognosis of patients with myocardial infarction (MI).MethodsWe searched PubMed, EMBASE, the Cochrane Library, and Web of Science from inception to July 2, 2023, to retrieve all relevant clinical trials. Associations between TMAO levels, major adverse cardiovascular events (MACE), all-cause mortality, recurrent MI, stroke, etc., were systematically addressed. Outcomes included MACE, all-cause mortality, recurrent MI, rehospitalization caused by heart failure, stroke, revascularization, SYNTAX score, and multivessel disease. A fixed/random-effects model should be adopted to calculate the pooled estimates. Besides, funnel plot, Begg's test and Egger' test were used to test publication bias.ResultsA total of nine studies were included in our meta-analysis. Our results indicated that higher TMAO levels were associated with greater risk of MACE (RR = 1.94; 95% CI = 1.39 to 2.73), all-cause mortality (RR = 1.56; 95% CI = 1.00 to 2.44), and MI (RR = 1.21; 95% CI = 1.01 to 1.45). No significant association was found in stroke, SYNTAX, and multivessel disease. Besides, our results reported that the association between TMAO levels and MACE after MI was not affected by the geographic localization.ConclusionThis study was the first meta-analysis that showed a significant positive association of TMAO levels with MACE, all-cause mortality, and recurrent MI in patients with MI.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=460400, PROSPERO (CRD42023460400).https://www.frontiersin.org/articles/10.3389/fcvm.2024.1334730/fulltrimethylamine N-oxidemyocardial infarctionall-cause mortalitymeta-analysismajor adverse cardiovascular events
spellingShingle Xiuqing Li
Yubao Wang
Jie Xu
Kaili Luo
Tao Dong
Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis
Frontiers in Cardiovascular Medicine
trimethylamine N-oxide
myocardial infarction
all-cause mortality
meta-analysis
major adverse cardiovascular events
title Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis
title_full Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis
title_fullStr Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis
title_full_unstemmed Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis
title_short Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis
title_sort association between trimethylamine n oxide and prognosis of patients with myocardial infarction a meta analysis
topic trimethylamine N-oxide
myocardial infarction
all-cause mortality
meta-analysis
major adverse cardiovascular events
url https://www.frontiersin.org/articles/10.3389/fcvm.2024.1334730/full
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