Martin F Reiner1, Daniel Müller2, Sara Gobbato3, Odile Stalder4, Andreas Limacher4, Nicole R Bonetti3, Lisa Pasterk3, Marie Méan5, Nicolas Rodondi6, Drahomir Aujesky7, Anne Angelillo-Scherrer8, Christian M Matter9, Thomas F Lüscher10, Giovanni G Camici11, Arnold von Eckardstein2, Jürg H Beer12. 1. Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland; Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland. Electronic address: martin.reiner@gmx.at. 2. Institute of Clinical Chemistry, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 3. Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland; Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland. 4. CTU Bern and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. 5. Division of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland. 6. Department of General Internal Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland. 7. Department of General Internal Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland. 8. Service and Central Laboratory of Hematology, Lausanne University Hospital, Lausanne, Switzerland. 9. Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland. 10. Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland; Royal Brompton and Harefield Hospital Trust and Imperial College, London, United Kingdom. 11. Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland. 12. Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland; Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland. Electronic address: hansjuerg.beer@ksb.ch.
Abstract
INTRODUCTION: Gut microbiota-dependent trimethylamine-N-oxide (TMAO) correlates with arterial thrombotic events including myocardial infarction and stroke, and mortality. However, the association of TMAO with recurrent venous thromboembolism (VTE) and mortality remains unknown. METHODS: TMAO plasma levels were assessed by high performance liquid chromatography in 859 patients aged ≥65 years with acute VTE and categorized into low (<2.28 μmol/L), medium (2.28-6.57 μmol/L), and high levels (>6.57 μmol/L) based on the 25th and 75th percentile. Associations of TMAO with recurrent VTE, major or non-major bleeding, and mortality were investigated. RESULTS: During a mean follow-up of 28 months, 106 patients developed recurrent VTE, 259 had major or non-major bleeding events, and 179 patients died. The risk of recurrent VTE did not differ significantly between patients with low, medium (adjusted subhazard ratio [SHR], 1.38; 95% confidence interval [CI], 0.81 to 2.36; p = 0.232) and high TMAO levels (SHR, 1.44; 95% CI, 0.80 to 2.58, p = 0.221). Compared with low TMAO levels, the adjusted hazard ratio [HR] for mortality was 0.68 (95% CI, 0.47 to 0.98, p = 0.039) in patients with medium TMAO levels and 1.02 (95% CI, 0.68 to 1.52, p = 0.922) in patients with high TMAO levels. Fractional polynomial Cox-regression confirmed a U-shaped association (adjusted p = 0.045), with the lowest mortality risk in patients with TMAO around 4 μmol/L. TMAO was not associated with major or non-major bleeding. CONCLUSION: TMAO showed a U-shaped association with mortality in elderly patients with acute VTE and was not associated with recurrent VTE and major or non-major bleeding.
INTRODUCTION: Gut microbiota-dependent trimethylamine-N-oxide (TMAO) correlates with arterial thrombotic events including myocardial infarction and stroke, and mortality. However, the association of TMAO with recurrent venous thromboembolism (VTE) and mortality remains unknown. METHODS:TMAO plasma levels were assessed by high performance liquid chromatography in 859 patients aged ≥65 years with acute VTE and categorized into low (<2.28 μmol/L), medium (2.28-6.57 μmol/L), and high levels (>6.57 μmol/L) based on the 25th and 75th percentile. Associations of TMAO with recurrent VTE, major or non-major bleeding, and mortality were investigated. RESULTS: During a mean follow-up of 28 months, 106 patients developed recurrent VTE, 259 had major or non-major bleeding events, and 179 patients died. The risk of recurrent VTE did not differ significantly between patients with low, medium (adjusted subhazard ratio [SHR], 1.38; 95% confidence interval [CI], 0.81 to 2.36; p = 0.232) and high TMAO levels (SHR, 1.44; 95% CI, 0.80 to 2.58, p = 0.221). Compared with low TMAO levels, the adjusted hazard ratio [HR] for mortality was 0.68 (95% CI, 0.47 to 0.98, p = 0.039) in patients with medium TMAO levels and 1.02 (95% CI, 0.68 to 1.52, p = 0.922) in patients with high TMAO levels. Fractional polynomial Cox-regression confirmed a U-shaped association (adjusted p = 0.045), with the lowest mortality risk in patients with TMAO around 4 μmol/L. TMAO was not associated with major or non-major bleeding. CONCLUSION:TMAO showed a U-shaped association with mortality in elderly patients with acute VTE and was not associated with recurrent VTE and major or non-major bleeding.
Authors: Paolo Marzullo; Laura Di Renzo; Gabriella Pugliese; Martina De Siena; Luigi Barrea; Giovanna Muscogiuri; Annamaria Colao; Silvia Savastano Journal: Int J Obes Suppl Date: 2020-07-20
Authors: Stephanie Andraos; Katherine Lange; Susan A Clifford; Beatrix Jones; Eric B Thorstensen; Jessica A Kerr; Melissa Wake; Richard Saffery; David P Burgner; Justin M O'Sullivan Journal: Curr Dev Nutr Date: 2020-06-10
Authors: Anne Jomard; Luca Liberale; Petia Doytcheva; Martin F Reiner; Daniel Müller; Michele Visentin; Marco Bueter; Thomas F Lüscher; Roberto Vettor; Thomas A Lutz; Giovanni G Camici; Elena Osto Journal: Sci Rep Date: 2022-05-23 Impact factor: 4.996
Authors: Stephanie Andraos; Beatrix Jones; Katherine Lange; Susan A Clifford; Eric B Thorstensen; Jessica A Kerr; Melissa Wake; Richard Saffery; David P Burgner; Justin M O'Sullivan Journal: Curr Dev Nutr Date: 2020-12-11