Metabolite of gut microbiota may predict subclinical myocardial damage

Higher plasma levels of trimethylamine-N-oxide (TMAO), a gut microbiota metabolite, seem to independently correlate with subclinical myocardial damage (SMD), a recent study has found.

Drawing from the Cohort of Patients at a High Risk of Cardiovascular Events–Thailand registry, researchers enrolled 134 patients with available TMAO data, of whom 123 had established atherosclerotic disease, while 11 had multiple underlying risk factors. The study objective was to assess the link between TMAO, as measured by spectroscopy, and SMD, as expressed by high-sensitivity cardiac troponin-T (hs-cTnT) levels.

Median TMAO concentration was 3.81 µM (interquartile range [IQR] 2.89–5.50 µM), while that for hs-cTnT was 15.65 ng/L (IQR 10.17–26.67 ng/L). Pearson correlation analysis found a significant link between TMAO and hs-cTnT levels (r, 0.54; p<0.0001). Similarly, TMAO concentrations were significantly elevated in participants with evidence of SMD.

Multivariate logistic regression analysis, adjusted for conventional risk factors such as age, sex, smoking, body mass index, and comorbidities, confirmed that an elevated plasma TMAO was significantly and independently predictive of SMD (adjusted odds ratio, 1.55, 95 percent confidence interval, 1.23–204; p=0.0007).

“Our findings shed light on a potential pathophysiological contribution of gut microbiota in the development of atherosclerosis and to adverse prognosis in patients with high atherosclerotic risk,” the researchers said.

“Further study is needed to determine whether therapeutic strategies that reduce plasma TMAO levels can also improve prognosis in these patients,” they added.