Trimethyllysine, a trimethylamine N-oxide precursor, provides near- and long-term prognostic value in patients presenting with acute coronary syndromes.

Details

Serval ID
serval:BIB_115AA6847135
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Trimethyllysine, a trimethylamine N-oxide precursor, provides near- and long-term prognostic value in patients presenting with acute coronary syndromes.
Journal
European heart journal
Author(s)
Li X.S., Obeid S., Wang Z., Hazen B.J., Li L., Wu Y., Hurd A.G., Gu X., Pratt A., Levison B.S., Chung Y.M., Nissen S.E., Tang WHW, Mach F., Räber L., Nanchen D., Matter C.M., Lüscher T.F., Hazen S.L.
ISSN
1522-9645 (Electronic)
ISSN-L
0195-668X
Publication state
Published
Issued date
21/08/2019
Peer-reviewed
Oui
Volume
40
Number
32
Pages
2700-2709
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Trimethyllysine (TML) serves as a nutrient precursor of the gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) and is associated with incident cardiovascular (CV) events in stable subjects. We examined the relationship between plasma TML levels and incident CV events in patients presenting with acute coronary syndromes (ACS).
Plasma levels of TML were quantified in two independent cohorts using mass spectrometry, and its relationship with CV events was investigated. In a Cleveland Cohort (N = 530), comprised of patients presenting to the emergency department with chest pain and suspected ACS, TML was associated with major adverse cardiac events (MACE, myocardial infarction, stroke, need for revascularization, or all-cause mortality) over both 30 days [3rd tertile (T3), adjusted odds ratio (OR) 1.77, 95% confidence interval (CI) 1.04-3.01; P < 0.05] and 6 months (T3, adjusted OR 1.95, 95% CI 1.15-3.32; P < 0.05) of follow-up independent of traditional CV risk factors and indices of renal function. Elevated TML levels were also associated with incident long-term (7-year) all-cause mortality [T3, adjusted hazard ratio (HR) 2.52, 95% CI 1.50-4.24; P < 0.001], and MACE even amongst patients persistently negative for cardiac Troponin T at presentation (e.g. 30-day MACE, T3, adjusted OR 4.49, 95% CI 2.06-9.79; P < 0.001). Trimethyllysine in combination with TMAO showed additive significance for near- and long-term CV events, including patients with 'negative' high-sensitivity Troponin T levels. In a multicentre Swiss Cohort (N = 1683) comprised of ACS patients, similar associations between TML and incident 1-year adverse cardiac risks were observed (e.g. mortality, adjusted T3 HR 2.74, 95% CI 1.28-5.85; P < 0.05; and MACE, adjusted T3 HR 1.55, 95% CI 1.04-2.31; P < 0.05).
Plasma TML levels, alone and together with TMAO, are associated with both near- and long-term CV events in patients with chest pain and ACS.
Keywords
Acute coronary syndromes, Gut microbiota, Incident major adverse cardiac events, Myocardial infarction, Trimethylamine N-oxide, Trimethyllysine, Acute coronary syndromes
Pubmed
Web of science
Create date
27/05/2019 18:06
Last modification date
31/10/2019 16:41
Usage data