In a study of 252 hemodialysis patients, high plasma levels (>4.73 μg/mL) were linked to a higher risk of mortality.
High TMAO levels were associated with increased rates of cardiovascular death.
A total of 123 patients died during the follow-up period, with significant mortality rates attributed to cardiovascular and cerebrovascular causes.
Kaplan-Meier analysis indicated a greater incidence of all-cause mortality in patients with high TMAO levels.
Cox regression analysis showed that high TMAO levels significantly predicted cardiovascular and all-cause mortality, even after adjusting for confounders.
Simplified
BACKGROUND: Trimethylamine--Oxide () is a proatherogenic and prothrombotic metabolite. Our study examined the association of plasma TMAO level with cardiovascular and all-cause mortality in hemodialysis (HD) patients. N
METHODS: Patients who were at least 18 years-old and received HD for at least 6 months were enrolled within 6 months. Patients with coronary heart disease, congestive heart failure, arrhythmia, or stroke within 3 months before study onset were excluded. The primary endpoints were cardiovascular and all-cause death, and the secondary endpoint was cerebrovascular death.
RESULTS: We recruited 252 patients and divided them into a high-TMAO group (>4.73 μg/mL) and a low-TMAO group (≤4.73 μg/mL). The median follow-up time was 73.4 months (interquartile range: 42.9, 108). A total of 123 patients died, 39 from cardiovascular disease, 19 from cerebrovascular disease, and 65 from other causes. Kaplan-Meier analysis indicated that the high-TMAO group had a greater incidence of cardiovascular death (Log-Rank: = 0.006) and all-cause death (Log-Rank: < 0.001). Cox regression analysis showed that high TMAO level was significantly associated with cardiovascular and all-cause mortality. After adjustment for confounding, this association remained significant for cardiovascular mortality (TMAO as a continuous variable: HR: 1.18, 95%CI: 1.07, 1.294, < 0.001; TMAO as a dichotomous variable: HR: 3.44, 95%CI: 1.68, 7.08, < 0.001) and all-cause mortality (TMAO as a continuous variable: HR: 1.14, 95%CI: 1.08, 1.21, < 0.001; TMAO as a dichotomous variable: HR: 2.54, 95%CI: 1.71, 3.76, < 0.001). p p p p p p
CONCLUSIONS: High plasma TMAO level is significantly and independently associated with cardiovascular and all-cause mortality in HD patients.
Key numbers
1.18
Increase in Cardiovascular Mortality Risk
Hazard ratio for as a continuous variable.
1.14
Increase in All-Cause Mortality Risk
Hazard ratio for as a continuous variable.
3.44
Higher Risk of Cardiovascular Death
Hazard ratio for as a dichotomous variable.
Full Text
We can’t show the full text here under this license.
The results presented in this paper have not been published previously in whole or part, except an abstract of this manuscript was presented earlier in ASN’s Kidney Week 2019 in Washington, DC (NO. 3236604).
