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SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.
Sec. Cardiovascular Metabolism
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1334730

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

Provisionally accepted
Xiuqing Li Xiuqing Li 1Yubao Wang Yubao Wang 2*Jie Xu Jie Xu 2Kaili Luo Kaili Luo 1*Tao Dong Tao Dong 1*
  • 1 Department of Gastroenterology and Hepatology, Zhenjiang Third People's Hospital, Zhenjiang, China
  • 2 Department of Cardiology, The Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, China

The final, formatted version of the article will be published soon.

    Background: Trimethylamine 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). Methods: We 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. Results: A 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. Conclusion: This 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.

    Keywords: Trimethylamine N-oxide, Myocardial Infarction, All-cause mortality, metaanalysis, Major adverse cardiovascular events

    Received: 01 Dec 2023; Accepted: 04 Nov 2024.

    Copyright: © 2024 Li, Wang, Xu, Luo and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yubao Wang, Department of Cardiology, The Affiliated Lianyungang Oriental Hospital of Kangda College of Nanjing Medical University, Lianyungang, China
    Kaili Luo, Department of Gastroenterology and Hepatology, Zhenjiang Third People's Hospital, Zhenjiang, China
    Tao Dong, Department of Gastroenterology and Hepatology, Zhenjiang Third People's Hospital, Zhenjiang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.