Aortic & peripheral vascular diseaseCohort study
Circulating Trimethylamine N-Oxide and Growth Rate of Abdominal Aortic Aneurysms and Surgical Risk
- Prospective cohort study
- 2 independent cohorts
- single-centre studies
- Data analysed October 2023 to May 2025
Authors' conclusion
Results of this cohort study suggest that elevated circulating TMAO levels were associated with increased risk of AAA and identified patients at heightened risk for fast-growing AAA and recommended surgical intervention.
Study context
- Population
- Patients undergoing serial imaging surveillance of the aorta and long-term outcome monitoring
- Participants
- 237 vs 658
- Exposure
- Elevated vs lower circulating TMAO
- Europeann = 237
- USn = 658
- Outcome
- Association of TMAO with AAA risk, fast-growing AAA (≥4.0 mm per year) and recommended surgical intervention (≥4.0 mm per year or ≥5.5 cm diameter)
Main finding
As reported in the abstract
Fast-growing AAA (≥4.0 mm per year) and recommended surgical intervention (≥4.0 mm per year or ≥5.5 cm diameter), by TMAO level
Adjusted odds ratio (95% CI)
Elevated TMAOfast-growing AAA
2.75(1.20–6.79)
Elevated TMAOrecommended surgical intervention
2.67(1.24–6.09)
US cohortfast-growing AAA, heightened TMAO
2.71(1.53–4.80)
combined cohortfast-growing AAA, heightened TMAO
2.30(1.47–3.62)
US cohortrecommended surgical intervention, heightened TMAO
2.73(1.56–4.80)
combined cohortrecommended surgical intervention, heightened TMAO
2.41(1.55–3.74)
Per year, as printed
Observational data: associations, not effects.
Further findings
Added value of TMAO to base models with traditional CV risk factors
- Significant improvement in risk estimation for fast-growing abdominal aortic aneurysms (AAA) and predicting recommended surgical intervention
Original publication
Circulating Trimethylamine N-Oxide and Growth Rate of Abdominal Aortic Aneurysms and Surgical Risk. JAMA Cardiol. Published 1 October 2025. doi:10.1001/jamacardio.2025.2698
Summarised from the published abstract; every number is checked against it