Trimethylamine-N-oxide (TMAO) predicts short- and long-term mortality and poor neurological outcome in out-of-hospital cardiac arrest patients.
Aged
Biomarkers
/ blood
Female
Gastrointestinal Microbiome
Hospital Mortality
/ ethnology
Hospitalization
Humans
Male
Methylamines
/ blood
Middle Aged
Multivariate Analysis
Odds Ratio
Out-of-Hospital Cardiac Arrest
/ mortality
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
cardiac arrest
metabolomics
outcome prediction
Journal
Clinical chemistry and laboratory medicine
ISSN: 1437-4331
Titre abrégé: Clin Chem Lab Med
Pays: Germany
ID NLM: 9806306
Informations de publication
Date de publication:
31 08 2020
31 08 2020
Historique:
received:
15
02
2020
accepted:
06
08
2020
pubmed:
1
9
2020
medline:
22
9
2021
entrez:
1
9
2020
Statut:
epublish
Résumé
Prior research found the gut microbiota-dependent and pro-atherogenic molecule trimethylamine-N-oxide (TMAO) to be associated with cardiovascular events as well as all-cause mortality in different patient populations with cardiovascular disease. Our aim was to investigate the prognostic value of TMAO regarding clinical outcomes in patients after out-of-hospital cardiac arrest (OHCA). We included consecutive OHCA patients upon intensive care unit admission into this prospective observational study between October 2012 and May 2016. We studied associations of admission serum TMAO with in-hospital mortality (primary endpoint), 90-day mortality and neurological outcome defined by the Cerebral Performance Category (CPC) scale. We included 258 OHCA patients of which 44.6% died during hospitalization. Hospital non-survivors showed significantly higher admission TMAO levels (μmol L-1) compared to hospital survivors (median interquartile range (IQR) 13.2 (6.6-34.9) vs. 6.4 (2.9-15.9), p<0.001). After multivariate adjustment for other prognostic factors, TMAO levels were significantly associated with in-hospital mortality (adjusted odds ratios (OR) 2.1, 95%CI 1.1-4.2, p=0.026). Results for secondary outcomes were similar with significant associations with 90-day mortality and neurological outcome in univariate analyses. In patients after OHCA, TMAO levels were independently associated with in-hospital mortality and other adverse clinical outcomes and may help to improve prognostication for these patients in the future. Whether TMAO levels can be influenced by nutritional interventions should be addressed in future studies.
Identifiants
pubmed: 32866111
doi: 10.1515/cclm-2020-0159
pii: cclm-2020-0159
doi:
Substances chimiques
Biomarkers
0
Methylamines
0
trimethyloxamine
FLD0K1SJ1A
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
393-402Références
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