Volume 23 Issue 8
Aug.  2025
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(8): 1328-1332
HE Ming, HE Chaojie, LIU Jintao, HU Yanyan, ZHU Yongjin. Association between intestinal flora metabolite trimethylamine oxide and 2-year cardiovascular event risk in STEMI Patients after PCI[J]. Chinese Journal of General Practice, 2025, 23(8): 1328-1332. doi: 10.16766/j.cnki.issn.1674-4152.004126
Citation: HE Ming, HE Chaojie, LIU Jintao, HU Yanyan, ZHU Yongjin. Association between intestinal flora metabolite trimethylamine oxide and 2-year cardiovascular event risk in STEMI Patients after PCI[J]. Chinese Journal of General Practice, 2025, 23(8): 1328-1332. doi: 10.16766/j.cnki.issn.1674-4152.004126
shu

Association between intestinal flora metabolite trimethylamine oxide and 2-year cardiovascular event risk in STEMI Patients after PCI

doi: 10.16766/j.cnki.issn.1674-4152.004126
  • 1.

    Department of Cardiology, Jiaxing Traditional Chinese Medicine Hospital, Jiaxing, Zhejiang 314000, China

Funds:

 LQ23H020001

  • Received Date: 2025-01-08
    Available Online: 2025-10-31
    Abstract
  •   Objective  Trimethylamine oxide (TMAO), a metabolite of intestinal flora, has been shown to be closely associated with the occurrence of cardiovascular disease (CVD). This study further investigated the association between TMAO and major adverse cardiovascular events (MACE) at 2 years after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).  Methods  A total of 158 STEMI patients who successfully underwent PCI treatment at Jiaxing Hospital of Traditional Chinese Medicine from June 2021 to December 2022 were prospectively selected and recorded (STEMI group). During the 2-year follow-up period after PCI, those with MACE and those without MACE were respectively classified as the MACE group and the No-MACE group. Another 40 healthy volunteers of the same age were selected and recorded as the control group. The plasma TMAO level was compared between different groups, and the relationship between plasma TMAO and MACE occurrence 2 years after PCI in STEMI group was analyzed by logistic stepwise analysis and ROC curve.  Results  Plasma TMAO [4.81 (4.12, 7.48) μmol/L vs. 2.25 (1.48, 2.60) μmol/L] in STEMI group was higher than that in control group (Z=14.057, P<0.001). There were 48 cases in the MACE group and 102 cases in the No-MACE group, respectively. Age, diabetes history, serum soluble growth stimulation expression factor 2 (sST2), N-terminal brain natriuretic peptide precursor (NT-proBNP) and TMAO in MACE group were higher than those in No-MACE group, and the differences were statistically significant (P<0.05). After modifying the collinearity of independent variables, stepwise logistic analysis showed that diabetes history and higher age, sST2, TMAO were independent risk factors for MACE 2 years after PCI in STEMI group (P<0.05). The predicted cutoff value of TMAO was 5.13 μmol/L, and the area under the curve (AUC) was higher than that of sST2 (P<0.05).  Conclusion  The plasma TMAO level of STEMI patients is abnormally elevated, and those with a higher level of TMAO have a higher risk of MACE occurrence. The plasma TMAO level has a good predictive value for MACE 2 years after PCI.

     

    • FullText(HTML)
  • loading
    • References(20)
  • [1]
    LEWIS C V, TAYLOR W R. Intestinal barrier dysfunction as a therapeutic target for cardiovascular disease[J]. Am J Physiol Heart Circ Physiol, 2020, 319(6): H1227-H1233. doi: 10.1152/ajpheart.00612.2020
    [2]
    彭园园, 陈碧莲. 氧化三甲胺影响冠心病和抗血小板药物疗效的研究进展[J]. 中国临床药理学与治疗学, 2024, 29(5): 590-595. PENG Y Y, CHEN B L. Research progress of the effect of TMAO on coronary heart disease and the efficacy of antiplatelet drugs[J]. 中国临床药理学与治疗学, 2024, 29(5): 590-595.
    [3]
    张新超, 于学忠, 陈凤英, 等. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 临床急诊杂志, 2019, 20(4): 253-262.

    ZHANG X C, YU X Z, CHEN F Y, et al. Emergency Rapid Diagnosis and Treatment Guidelines for Acute Coronary Syndrome (2019)[J]. Journal of Clinical Emergency, 2019, 20(4): 253-262.
    [4]
    中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志, 2019, 47(10): 766-783.

    Cardiovascular Branch of Chinese Medical Association, Editorial Committee of Chinese Journal of Cardiovascular Diseases. 2019 Chinese Society of Cardiology (CSC) guidelines for the diagnosis and management of patients with ST? segment elevation myocardial infarction[J]. Chinese Journal of Cardiology, 2019, 47(10): 766-783.
    [5]
    杨晖, 段霁芸, 易雯霞, 等. 急性缺血性卒中合并糖尿病患者氧化三甲胺、视锥蛋白样蛋白-1、NLR家族含CARD结构蛋白4与神经功能恶化的相关性分析[J]. 北京医学, 2024, 46(12): 1064-1068.

    YANG H, DUAN J Y, YI W X, et al. Relationship between trimetlylamine N-oxide, recombinant visinin like protein 1, NLR family CARD domain containing 4 and neurological deterioration in acute ischemic stroke patients with diabetes mellitus[J]. Chinese General Practice, 2024, 46(12): 1064-1068.
    [6]
    中国心血管健康与疾病报告编写组, 胡盛寿, 王增武. 《中国心血管健康与疾病报告2022》概要[J]. 中国介入心脏病学杂志, 2023, 31(7): 485-508.

    The Writing Committee of the Report on Cardiovascular Health and Diseases in China, HU S S, WANG Z W. Report on cardiovascular health and diseases in China 2022: an updated summary[J]. Chinese Journal of Interventional Cardiology, 2023, 31(7): 485-508.
    [7]
    李兆, 程功, 王依阳. 急性心肌梗死患者PCI术后发生MACE的危险因素及其预测价值[J]. 中国循证心血管医学杂志, 2022, 14(10): 1212-1216.

    LI Z, CHENG G, WANG Y Y. Risk factors and predictive value of MACE incidence in patients with acute myocardial infarction after percutaneous coronary intervention[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2022, 14(10): 1212-1216.
    [8]
    杨晓明, 郑祥, 王超超. 肠道菌群代谢产物与冠心病合并慢性心力衰竭的相关性及对患者预后水平的预测作用[J]. 中华全科医学, 2023, 21(10): 1676-1678, 1718. doi: 10.16766/j.cnki.issn.1674-4152.003198

    YANG X M, ZHENG X, WANG C C. Correlation between gut microbiota metabolites and coronary heart disease combined with chronic heart failure and its predictive role in patient prognosis[J]. Chinese Journal of General Practice, 2023, 21(10): 1676-1678, 1718. doi: 10.16766/j.cnki.issn.1674-4152.003198
    [9]
    李晓红, 王鹏飞, 吴广, 等. 肠道菌群与急性心肌梗死的相关性研究[J]. 中国心血管杂志, 2021, 26(4): 385-389.

    LI X H, WANG P F, WU G, et al. Study on the relationship between intestinal flora and acute myocardial infarction[J]. Chinese Journal of Cardiovascular Medicine, 2021, 26(4): 385-389.
    [10]
    陈先慧, 马玉兰. 氧化三甲胺与心房颤动相关的研究进展[J]. 中华全科医学, 2024, 22(6): 1033-1037, 1063. doi: 10.16766/j.cnki.issn.1674-4152.003560

    CHEN X H, MA Y L. Research progress on the relationship between trimethylamine oxide and atrial fibrillation[J]. Chinese Journal of General Practice, 2024, 22(6): 1033-1037, 1063. doi: 10.16766/j.cnki.issn.1674-4152.003560
    [11]
    董素娟, 汪凛, 杨广龙. 急性冠状动脉综合征患者血浆氧化三甲胺水平与病情严重程度的相关性分析[J]. 中国医师进修杂志, 2020, 43(5): 462-466.

    DONG S J, WANG L, YANG G L. Expression of plasma trimethylamine oxide in patients with acute coronary syndrome and its correlation with disease severity[J]. Chinese Journal of Postgraduates of Medicine, 2020, 43(5): 462-466.
    [12]
    郭莉, 贾晓静, 邢园园, 等. 冠心病患者肠道菌群代谢产物TMAO与PCI术后短期疗效的相关性[J]. 医学综述, 2023, 29(20): 4331-4335.

    GUO L, JIA X J, XING Y Y, et al. Correlation between Metabolite of Intestinal Flora TMAO and Short-term Efficacy after PCI in Patients with Coronary Heart Disease[J]. Medical Recapitulate, 2023, 29(20): 4331-4335.
    [13]
    ALDUJELI A, TSAI TY, HAQ A, et al. The association between trimethylamine N-oxide levels and coronary microvascular dysfunction and prognosis in patients with ST-elevation myocardial infarction[J]. Atherosclerosis, 2024, 39(8): 85-97.
    [14]
    兰琪, 刘孟楠, 伍浩, 等. sST2在心血管疾病中的应用价值[J]. 中国循证心血管医学杂志, 2024, 16(5): 634-636.

    LAN Q, LIU M N, WU H, et al. Application value of sST2 in cardiovascular diseases[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2024, 16(5): 634-636.
    [15]
    WITKOWSKI M, WEEKS T L, HAZEN S L. Gut microbiota and cardiovascular disease[J]. Circ Res, 2020, 127(4): 553-570. doi: 10.1161/CIRCRESAHA.120.316242
    [16]
    徐雁云, 陈民利. 肠道菌群与肠屏障互作影响动脉粥样硬化形成的研究进展[J]. 中国实验动物学报, 2022, 30(7): 973-982.

    XU Y Y, CHEN M L. Research progress in the interaction between intestinal flora and the intestinal barrier in atherosclerosis[J]. Acta Laboratorium Animalis Scientia Sinica, 2022, 30(7): 973-982.
    [17]
    杨梅芳, 程萍, 陈治任, 等. 肠道菌群代谢产物TMAO激活HMGB1/NLRP3炎症通路促进小鼠脑缺血半暗带损伤的机制研究[J]. 中风与神经疾病杂志, 2023, 40(12): 1096-1100.

    YANG M F, CHENG P, CHEN Z R, et al. echanism of gut microbiota metabolite TMAO activating inflammatory pathway HMGB1/NLRP3 to promote cerebral ischemic penumbra damage in mice[J]. Journal of Apoplexy and Nervous Diseases, 2023, 40(12): 1096-1100.
    [18]
    马瑞松, 胡小春, 王苗, 等. 氧化三甲胺对氯吡格雷抗血小板聚集的抑制作用观察[J]. 山东医药, 2022, 62(33): 9-12.

    MA R S, HU X C, WANG M, et al. Inhibitory effect of TMAO on anti-platelet aggregation effects of clopidogrel[J]. Shandong Medical Journal, 2022, 62(33): 9-12.
    [19]
    李加英. 氧化三甲胺通过调节内质网-线粒体应激促进钙化性主动脉瓣疾病发生发展的机制研究[D]. 广州: 南方医科大学, 2025.

    LI J Y. Research on the Mechanism of Trimethylamine Oxide Promoting the Occurrence and Development of Calcifying Aortic Valve Disease by Regulating Endoplasmic Reticulum-Mitochondrial Stress[D]. Guangzhou: Southern Medical University, 2025.
    [20]
    李佳玲, 闾宏伟, 陈淑华, 等. 氧化三甲胺通过ALDH2/ROS/NLRP3/GSDMD通路诱导血管内皮细胞焦亡[J]. 中南大学学报: 医学版, 2022, 47(9): 1171-1181.

    LI J L, LU H W, CHEN S H, et al. Trimethylamine oxide induces pyroptosis of vascular endothelial cells through ALDH2/ROS/NLRP3/GSDMD pathway[J]. Journal of Central South University: Medical Science, 2022, 47(9): 1171-1181.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (3) PDF downloads(0) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return