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Prognostic Value of Elevated Levels of Intestinal Microbe-Generated Metabolite Trimethylamine-N-Oxide in Patients With Heart Failure
Higher levels of a gut microbe chemical called trimethylamine-N-oxide linked to outcomes in heart failure patients
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Abstract
The median trimethylamine-N-oxide (TMAO) level in patients with heart failure was 5.0 μM, significantly higher than the 3.5 μM found in subjects without heart failure.
- A modest but significant correlation exists between TMAO concentrations and B-type natriuretic peptide (BNP) levels (r = 0.23; p < 0.001).
- Higher plasma TMAO levels are associated with a 3.4-fold increased risk of all-cause mortality.
- Elevated TMAO levels remain predictive of 5-year mortality risk even after adjusting for traditional risk factors and BNP levels (hazard ratio: 2.2; 95% CI: 1.42 to 3.43; p < 0.001).
- The predictive value of TMAO for mortality risk persists after including estimated glomerular filtration rate in the analysis (hazard ratio: 1.75; 95% CI: 1.07 to 2.86; p < 0.001).
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