Prevention & lipids

Trimethylamine N-oxide is associated with long-term mortality risk: the multi-ethnic study of atherosclerosis

Eur Heart JPublished Prospective cohort study

Authors' conclusion

Plasma TMAO levels were positively associated with mortality, especially deaths due to cardiovascular and renal disease, in a multi-ethnic US cohort.

Study context

Population
Adults from the Multi-Ethnic Study of Atherosclerosis (US)
Participants
6,785 adults
Exposure
Higher vs lower plasma TMAO; annualized change in TMAO
Outcome
Adjudicated all-cause mortality and CVD mortality
Follow-up
Median 16.9 years
Methodological detailsmulti-ethnic, community-based
  • Multi-ethnic
  • Community-based

Main finding

As reported in the abstract

Higher TMAO (per inter-quintile range)Hazard ratio (95% CI)
All-cause mortality
1.12(1.08–1.17)
CVD mortality
1.09(1.00–1.09)

Per inter-quintile range, as printed

Deaths
1704
Cardiovascular disease (CVD) deaths
411

Observational data: associations, not effects.

Secondary outcomes

OutcomeHR (95% CI)
Death due to kidney failure · median follow-up 16.9 yearsPer inter-quintile range · time-varying TMAO; adjusted Cox models1.44 (1.25–1.66)

All-cause mortality, by annualized changes in TMAO levels

HR (95% CI)
Annualized changes in TMAO levels1.10 (1.05–1.14)

Death due to kidney failure, by annualized changes in TMAO levels

HR (95% CI)
Annualized changes in TMAO levels1.54 (1.26–1.89)

Deaths due to cancer or dementia

Higher TMAO levels not associated with deaths due to cancer or dementia

Other deaths, by annualized changes in TMAO levels

Annualized changes in TMAO levels not associated with other deaths

Original publication

Trimethylamine N-oxide is associated with long-term mortality risk: the multi-ethnic study of atherosclerosis. Eur Heart J. Published 8 March 2023. doi:10.1093/eurheartj/ehad089

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