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TMAO as a biomarker of cardiovascular events: a systematic review and meta-analysis

  • CE-Systematic reviews and meta-analysis
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Abstract

Background

Unmasking the residual cardiovascular risk is a major research challenge in the attempt to reduce cardiovascular disease (CVD) morbidity and mortality. Mounting evidence suggests that a high circulating level of trimethylamine N-oxide is a new potential CVD risk factor. We performed a systematic review of the published studies to clarify the association between circulating high levels of TMAO and cardiovascular events.

Methods

Studies evaluating the association between TMAO and CVD events were searched by electronic databases up to December 2018. Pooled results were expressed as risk ratio (RR) with 95% pertinent confidence interval (CI).

Results

Three studies for a total of 923 patients at high/very high CVD risk were included in our analysis. Overall, a high TMAO level was associated with both major adverse cardiovascular events (RR = 2.05; 95% CI 1.61–2.61) and all-cause mortality (RR = 3.42; 95% CI 2.27–5.15).

Conclusions

Our findings support a role of high TMAO levels in predicting CVD events. High levels of TMAO may be a new CVD risk factor, potentially useful to better plan personalized CVD prevention strategies.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Medicine and Surgery, University of Insubria, Varese, Como, Italy

    Luigina Guasti, Eleonora Visconti, Benedetta Pennella, Giovanni Vincenzo Gaudio, Alessandro Lupi, Anna Maria Grandi & Alessandro Squizzato

  2. Internal Medicine Unit, Ospedale S.Valentino, Montebelluna, Treviso, Italy

    Silvia Galliazzo

  3. Ospedale Metropolitano Niguarda, Milan, Italy

    Marta Molaro

  4. U.O.C Medicina Generale, ASST Lariana-Ospedale S.Anna,, Via Ravona, 20, 22042, San Fermo della Battaglia, Como, Italy

    Alessandro Squizzato

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  1. Luigina Guasti
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  2. Silvia Galliazzo
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  4. Eleonora Visconti
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Correspondence to Alessandro Squizzato.

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Guasti, L., Galliazzo, S., Molaro, M. et al. TMAO as a biomarker of cardiovascular events: a systematic review and meta-analysis. Intern Emerg Med 16, 201–207 (2021). https://doi.org/10.1007/s11739-020-02470-5

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  • DOI: https://doi.org/10.1007/s11739-020-02470-5

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