Yu Tan1, Jinying Zhou2, Chen Liu2, Peng Zhou2, Zhaoxue Sheng2, Jiannan Li2, Runzhen Chen2, Li Song2, Hanjun Zhao2, Bo Xu2, Runlin Gao2, Hongbing Yan3. 1. Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China. 2. Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. 3. Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. Electronic address: hbyanfuwai@aliyun.com.
Abstract
BACKGROUND: Trimethylamine N-oxide (TMAO) has been shown to promote the development of atherosclerosis. However, the relationship between plasma TMAO and neoatherosclerosis, an important underlying mechanism of very late stent thrombosis (VLST), is unknown. METHODS: This post hoc study investigated the association between TMAO and neoatherosclerosis in 2 independent cohorts. These included a control group of 50 healthy volunteers and a study cohort of 50 patients with VLST who presented with ST-segment elevation myocardial infarction and underwent optical coherence tomography examination. Of the 50 patients with VLST, 23 had neoatherosclerosis and 27 did not have neoatherosclerosis. Patients with neoatherosclerosis were further divided into 2 subgroups, including 14 patients with plaque rupture and 9 without plaque rupture. RESULTS: The plasma TMAO levels, detected using mass spectrometry, were significantly higher in patients with VLST than in healthy individuals (median [interquartile range], 2.50 [1.67-3.84] vs 1.32 [0.86-2.44] μM; P < 0.001). Among the patients with VLST, the plasma TMAO levels were significantly higher in patients with neoatherosclerosis than in those without neoatherosclerosis (3.69 [2.46-5.29] vs 1.96 [1.39-2.80] μM; P < 0.001). In addition, in patients with neoatherosclerosis, patients with plaque rupture had significantly higher plasma TMAO concentrations than those without plaque rupture (4.51 [3.41-5.85] vs 2.46 [2.05-3.55] μM; P = 0.005). Multivariate analysis indicated that TMAO was an independent predictor of neoatherosclerosis (odds ratio, 3.41; 95% confidence interval, 1.59-7.30; P = 0.002). Moreover, the area under the receiver operating characteristic curve for TMAO, differentiated by neoatherosclerosis, was 0.85. CONCLUSIONS: Plasma TMAO was significantly correlated with neoatherosclerosis and plaque rupture in patients with VLST.
BACKGROUND:Trimethylamine N-oxide (TMAO) has been shown to promote the development of atherosclerosis. However, the relationship between plasma TMAO and neoatherosclerosis, an important underlying mechanism of very late stent thrombosis (VLST), is unknown. METHODS: This post hoc study investigated the association between TMAO and neoatherosclerosis in 2 independent cohorts. These included a control group of 50 healthy volunteers and a study cohort of 50 patients with VLST who presented with ST-segment elevation myocardial infarction and underwent optical coherence tomography examination. Of the 50 patients with VLST, 23 had neoatherosclerosis and 27 did not have neoatherosclerosis. Patients with neoatherosclerosis were further divided into 2 subgroups, including 14 patients with plaque rupture and 9 without plaque rupture. RESULTS: The plasma TMAO levels, detected using mass spectrometry, were significantly higher in patients with VLST than in healthy individuals (median [interquartile range], 2.50 [1.67-3.84] vs 1.32 [0.86-2.44] μM; P < 0.001). Among the patients with VLST, the plasma TMAO levels were significantly higher in patients with neoatherosclerosis than in those without neoatherosclerosis (3.69 [2.46-5.29] vs 1.96 [1.39-2.80] μM; P < 0.001). In addition, in patients with neoatherosclerosis, patients with plaque rupture had significantly higher plasma TMAO concentrations than those without plaque rupture (4.51 [3.41-5.85] vs 2.46 [2.05-3.55] μM; P = 0.005). Multivariate analysis indicated that TMAO was an independent predictor of neoatherosclerosis (odds ratio, 3.41; 95% confidence interval, 1.59-7.30; P = 0.002). Moreover, the area under the receiver operating characteristic curve for TMAO, differentiated by neoatherosclerosis, was 0.85. CONCLUSIONS: Plasma TMAO was significantly correlated with neoatherosclerosis and plaque rupture in patients with VLST.
Authors: Yuan Fu; Yixing Yang; Chen Fang; Xinming Liu; Ying Dong; Li Xu; Mulei Chen; Kun Zuo; Lefeng Wang Journal: Front Cardiovasc Med Date: 2022-08-30
Authors: Yen Chin Koay; Yung-Chih Chen; Jibran A Wali; Alison W S Luk; Mengbo Li; Hemavarni Doma; Rosa Reimark; Maria T K Zaldivia; Habteab T Habtom; Ashley E Franks; Gabrielle Fusco-Allison; Jean Yang; Andrew Holmes; Stephen J Simpson; Karlheinz Peter; John F O'Sullivan Journal: Cardiovasc Res Date: 2021-01-21 Impact factor: 10.787