Gąsecka Aleksandra, Fidali Oliwia, Kłębukowska Aleksandra, Jasińska-Gniadzik Karolina, Szwed Piotr, Witkowska Karolina, Eyileten Ceren, Postuła Marek, Grabowski Marcin, Filipiak Krzysztof J, Ufnal Marcin
1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, Warsaw, Poland.
Postepy Kardiol Interwencyjnej. 2023 Mar;19(1):31-39. doi: 10.5114/aic.2022.123884. Epub 2023 Jan 23.
Plasma concentrations of gut microbial metabolites are associated with cardiomyocyte viability and platelet reactivity. We hypothesized that increased concentrations of gut metabolites may predict major adverse cardiac and cerebrovascular events (MACCE) after acute myocardial infarction (AMI).
The primary objective of this study was to evaluate the association between elevated plasma concentrations of gut metabolites and MACCE after AMI.
We compared plasma concentrations of gut metabolites (trimethylamine-N-oxide (TMAO) and indoxyl sulphate (IS)) and platelet reactivity in 57 patients with AMI and 27 healthy controls. We assessed the predictive value of gut metabolites for MACCE (stroke, recurrent AMI, death) over a median of 3.5-years.
The concentrations of TMAO and IS did not differ between AMI patients and controls. The concentrations of TMAO and IS were higher in patients who developed MACCE than in those who did not ( ≤ 0.015 for all). The concentration of TMAO was the only independent predictor of MACCE in a multivariate analysis (OR = 35.041, 95% CI: 1.269-967.307, = 0.036). Patients with the concentration of TMAO and indoxyl sulphate above the cut-off value predictive of MACCE had higher platelet activity ( ≤ 0.149 for all).
Increased plasma concentration of TMAO is an independent predictor of MACCE and may contribute to post-AMI cardiac dysfunction.
肠道微生物代谢产物的血浆浓度与心肌细胞活力和血小板反应性相关。我们假设肠道代谢产物浓度升高可能预测急性心肌梗死（AMI）后主要不良心脑血管事件（MACCE）。
本研究的主要目的是评估AMI后血浆中肠道代谢产物浓度升高与MACCE之间的关联。
我们比较了57例AMI患者和27例健康对照者的肠道代谢产物（氧化三甲胺（TMAO）和硫酸吲哚酚（IS））血浆浓度及血小板反应性。我们评估了肠道代谢产物在3.5年中位数时间内对MACCE（中风、复发性AMI、死亡）的预测价值。
AMI患者和对照组之间TMAO和IS的浓度没有差异。发生MACCE的患者中TMAO和IS的浓度高于未发生MACCE的患者（所有P≤0.015）。在多变量分析中，TMAO浓度是MACCE的唯一独立预测因子（OR = 35.041，95%CI：1.269 - 967.307，P = 0.036）。TMAO和硫酸吲哚酚浓度高于预测MACCE的临界值的患者具有更高的血小板活性（所有P≤0.149）。
血浆TMAO浓度升高是MACCE的独立预测因子，可能导致AMI后心脏功能障碍。
Zotero 插件
