Aortic & peripheral vascular diseaseCohort study
Gut microbe-generated metabolite trimethylamine N-oxide and risk of abdominal aortic aneurysm: a cohort study
- Prospective cohort study
- community-based
Authors' conclusion
In community-based older adults, higher TMAO levels were independently associated with increased risk of AAA development and adverse AAA events.
Study context
- Population
- Community-dwelling adults aged ≥65 years in the Cardiovascular Health Study
- Participants
- 4,442 adults
- Exposure
- Higher vs lower plasma TMAO levels
- Outcome
- Adverse AAA events:
- Repair
- Rupture
- AAA-related death
- Follow-up
- median 12.2-year follow-up
Main finding
As reported in the abstract
Adverse AAA events · median 12.2 years (54 402 person-years)
Estimate (95% CI)
TMAO per doublingcontinuous
adjusted HR 1.28(1.07–1.54)
Tertile 3 vs Tertile 1
HR 2.46(1.32–4.59)
TMAO ≥6.2 µM vs Tertile 1clinical threshold
HR 1.93(1.25–2.99)
- Incident adverse AAA events
- 79
Observational data: associations, not effects.
Further findings
Infrarenal aortic diameter and AAA risk
- Higher baseline TMAO associated with larger infrarenal aortic diameter and increased AAA risk
Original publication
Gut microbe-generated metabolite trimethylamine N-oxide and risk of abdominal aortic aneurysm: a cohort study. Eur Heart J. Published 15 July 2026. doi:10.1093/eurheartj/ehag489
Summarised from the published abstract; every number is checked against it