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Meta-Analysis
. 2021 Jan;16(1):201-207.
doi: 10.1007/s11739-020-02470-5. Epub 2020 Aug 10.

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

Luigina Guasti  1 , Silvia Galliazzo  2 , Marta Molaro  3 , Eleonora Visconti  1 , Benedetta Pennella  1 , Giovanni Vincenzo Gaudio  1 , Alessandro Lupi  1 , Anna Maria Grandi  1 , Alessandro Squizzato  4   5
Affiliations
Meta-Analysis

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

Luigina Guasti et al. Intern Emerg Med. 2021 Jan.

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.

Keywords: Cardiovascular events; Gut microbiota; Trimethylamine oxide.

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