Ethnic differences in association of outcomes with trimethylamine N-oxide in acute heart failure patients.
ESC Heart Fail
; 7(5): 2373-2378, 2020 10.
Article
in En
| MEDLINE
| ID: mdl-32598563
ABSTRACT
AIMS:
The aim of this study was to investigate whether ethnicity influences the associations between trimethylamine N-oxide (TMAO) levels and heart failure (HF) outcomes. METHODS ANDRESULTS:
Trimethylamine N-oxide levels were measured in two cohorts with acute HF at two sites. The UK Leicester cohort consisted mainly of Caucasian (n = 842, 77%) and South Asian (n = 129, 12%) patients, whereas patients in the Japanese cohort (n = 116, 11%) were all Japanese. The primary endpoint was the measurement of all-cause mortality and/or HF rehospitalization within 1 year post-admission. Association of TMAO levels with outcome was compared in the entire population and between ethnic groups after adjustment for clinical parameters. TMAO levels were significantly higher in Japanese patients [median (interquartile range) 9.9 µM (5.2-22.8)] than in Caucasian [5.9 µM (3.6-10.8)] and South Asian [4.5 µM (3.1-8.4)] (P < 0.001) patients. There were no differences in the rate of mortality and/or HF rehospitalization between the ethnic groups (P = 0.096). Overall, higher TMAO levels showed associations with mortality and/or rehospitalization after adjustment for confounders ( P = 0.002). Despite no differences between ethnicity and association with mortality/HF after adjustment (P = 0.311), only in Caucasian patients were TMAO levels able to stratify for a mortality/HF event (P < 0.001).CONCLUSIONS:
Differences were observed in the association of mortality and/or rehospitalization based on circulating TMAO levels. Elevated TMAO levels in Caucasian patients showed increased association with adverse outcomes, but not in non-Caucasian patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heart Failure
/
Methylamines
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
ESC Heart Fail
Year:
2020
Document type:
Article
Affiliation country:
United kingdom