Abstract
Objective: Trimethylamine N-oxide (TMAO), a pathological microbial metabolite, is demonstrated to be related to cardiovascular diseases. This study was (1) to investigate the association between TMAO and aortic stenosis and (2) to determine the prognostic value of TMAO for predicting mortality after transcatheter aortic valve replacement (TAVR). Methods: 299 consecutive patients (77 (72–81) years, 58.2% male, Society of Thoracic Surgeons (STS) score 5.8 (4.9–9.3)) with severe aortic stenosis and 711 patients (59 (52–66) years, 51.9% male) without aortic stenosis were included in this retrospective study. A total of 126 pairs of patients were assembled by Propensity Score Matching. The primary outcome was all-cause mortality using survival analyses stratified by TMAO quartiles. Results: Patients with severe aortic stenosis had higher TMAO levels (3.18 (1.77–6.91) μmol/L vs. 1.78 (1.14–2.68) μmol/L, p < 0.001), and TMAO remained significantly higher after adjusting for baseline characteristics. Higher TMAO level was associated with higher 2-year all-cause mortality (19.2% vs. 9.5%, log-rank p = 0.028) and higher late cumulative mortality (34.2% vs. 19.1%, log-rank p = 0.004). In Cox regression multivariate analysis, higher TMAO level remained an independent predictor (hazard ratio 1.788; 95% CI 1.064–3.005, p = 0.028) of all-cause mortality after adjusting for STS score, N-terminal pro b-type natriuretic peptide, and maximum velocity. Conclusions: The TMAO level was higher in aortic stenosis patients. Elevated TMAO was associated with poor adverse outcome after TAVR.
Funder
Natural Science Foundation of Zhejiang Province of China
Reference26 articles.
1. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines;Otto;Circulation,2021
2. Transcatheter Aortic Valve Replacement in Asia;Lee;JACC Asia,2021
3. Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients;Popma;N. Engl. J. Med.,2019
4. GDF-15 (Growth Differentiation Factor 15) Is Associated With Lack of Ventricular Recovery and Mortality After Transcatheter Aortic Valve Replacement;Kim;Circ. Cardiovasc. Interv.,2017
5. YKL-40 (Chitinase-3-Like Protein 1) Serum Levels in Aortic Stenosis;Arain;Circ. Heart Fail.,2020
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献