1. Trimethylamine-N-oxide (TMAO) predicts short- and long-term mortality and poor neurological outcome in out-of-hospital cardiac arrest patients
- Author
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Kai Tisljar, Katharina Beck, Sebastian Perrig, Peter Neyer, Luca Bernasconi, Kerstin Metzger, Philipp Schuetz, Raoul Sutter, Annalena Keller, Stephan Marsch, Christoph Becker, Alessia Vincent, Sabina Hunziker, and Seraina Hochstrasser
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Clinical Biochemistry ,Trimethylamine N-oxide ,Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,law.invention ,Methylamines ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Risk Factors ,Interquartile range ,law ,Internal medicine ,Odds Ratio ,medicine ,Clinical endpoint ,Humans ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,Aged ,Univariate analysis ,business.industry ,Biochemistry (medical) ,General Medicine ,Odds ratio ,Middle Aged ,Prognosis ,Intensive care unit ,Gastrointestinal Microbiome ,Hospitalization ,Treatment Outcome ,chemistry ,Multivariate Analysis ,Female ,Observational study ,business ,Biomarkers ,Out-of-Hospital Cardiac Arrest - Abstract
Objectives 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). Methods 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. Results 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 Conclusions 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.
- Published
- 2020