Cohort study
Trimethylamine N-oxide is associated with long-term mortality risk: the multi-ethnic study of atherosclerosis
- Prospective cohort study
- multi-ethnic
- community-based
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
Main finding
As reported in the abstract
All-cause and CVD mortality per inter-quintile range of TMAO
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
| Outcome | HR (95% CI) | |
|---|---|---|
| Death due to kidney failure · median follow-up 16.9 years · per inter-quintile range · time-varying TMAO; adjusted Cox models | 1.44 (1.25–1.66) | |
| 0.512Hazard ratio (log scale) |
All-cause mortality, by annualized changes in TMAO levels
| Comparison | HR (95% CI) | |
|---|---|---|
| Annualized changes in TMAO levels | 1.10 (1.05–1.14) | |
| 0.512Hazard ratio (log scale) |
Death due to kidney failure, by annualized changes in TMAO levels
| Comparison | HR (95% CI) | |
|---|---|---|
| Annualized changes in TMAO levels | 1.54 (1.26–1.89) | |
| 0.512Hazard ratio (log scale) |
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
Summarised from the published abstract; every number is checked against it