Dingxu Gong1, Lin Zhang2, Ying Zhang3, Fang Wang4, Zhenwen Zhao5, Xianliang Zhou2. 1. Department of Cardiac Surgery. Electronic address: haregdx@163.com. 2. Department of Cardiology. 3. Peking Union Medical College, Department of Cardiology. 4. Department of Clinical Laboratory, Fuwai Hospital Chinese Academy of Medical Science and the National Center for Cardiovascular Disease of China, Beijing, China. 5. Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry Chinese Academy of Sciences, University of Chinese Academy of Sciences, Beijing, China.
Abstract
BACKGROUND: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia. Patients with AF are prone to forming cardiac thrombi. Elevated serum trimethylamine N-oxide (TMAO) levels are associated with increased thrombosis risk. No previous studies have examined the relationship between serum TMAO levels and thrombus formation in AF patients. MATERIALS AND METHODS: A total of 117 consecutive rheumatic heart disease patients with AF were enrolled. The patients were divided into 2 groups: patients with thrombi (n = 25) and patients without thrombi (n = 92). Platelet function tests were performed by light transmittance aggregometry. Serum TMAO, betaine and choline levels were quantified by liquid chromatography combined with tandem mass spectrometry. Results were compared between the 2 groups. The correlation between serum TMAO levels and thrombi formation was examined. RESULTS: No remarkable differences in demographic characteristics were found between the 2 groups. Serum TMAO levels were significantly higher in the thrombus group (4.55 UM [3.19-4.83] vs. 3.53 UM [2.96-4.25], P = 0.01). Enhanced platelet hyperreactivity was more likely in the thrombus group. Receiver operating characteristic analysis showed the diagnostic potential of serum TMAO levels to identify thrombus formation, with an area under the curve of 0.661 (P = 0.01, 95% confidence interval: 0.52-0.80). Binary regression analyses showed that serum TMAO had potent predictive power for thrombus formation (P < 0.01, 95% CI of 1.21-3.08). CONCLUSIONS: Elevated serum TMAO levels were predictive of thrombus formation in AF patients. Our results highlight the usefulness of serum TMAO levels in identifying individuals with increased susceptibility to thrombus formation, allowing development of precise thrombus prevention strategies.
BACKGROUND:Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia. Patients with AF are prone to forming cardiac thrombi. Elevated serum trimethylamine N-oxide (TMAO) levels are associated with increased thrombosis risk. No previous studies have examined the relationship between serum TMAO levels and thrombus formation in AFpatients. MATERIALS AND METHODS: A total of 117 consecutive rheumatic heart diseasepatients with AF were enrolled. The patients were divided into 2 groups: patients with thrombi (n = 25) and patients without thrombi (n = 92). Platelet function tests were performed by light transmittance aggregometry. Serum TMAO, betaine and choline levels were quantified by liquid chromatography combined with tandem mass spectrometry. Results were compared between the 2 groups. The correlation between serum TMAO levels and thrombi formation was examined. RESULTS: No remarkable differences in demographic characteristics were found between the 2 groups. Serum TMAO levels were significantly higher in the thrombus group (4.55 UM [3.19-4.83] vs. 3.53 UM [2.96-4.25], P = 0.01). Enhanced platelet hyperreactivity was more likely in the thrombus group. Receiver operating characteristic analysis showed the diagnostic potential of serum TMAO levels to identify thrombus formation, with an area under the curve of 0.661 (P = 0.01, 95% confidence interval: 0.52-0.80). Binary regression analyses showed that serum TMAO had potent predictive power for thrombus formation (P < 0.01, 95% CI of 1.21-3.08). CONCLUSIONS: Elevated serum TMAO levels were predictive of thrombus formation in AFpatients. Our results highlight the usefulness of serum TMAO levels in identifying individuals with increased susceptibility to thrombus formation, allowing development of precise thrombus prevention strategies.
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