Table 3.
Association between TMAO levels of V1 and V2 and all endpoints.
| Endpoint | Group | Event (n.%) | Crude HR (95%CI) | p-Value | Adjusted HR (95%CI) * | p-Value |
|---|---|---|---|---|---|---|
| MACE | ||||||
| L/L | 33 (21.3) | [1] | [1] | |||
| L/H | 17 (17.2) | 0.79 (0.44–1.42) | 0.433 | 1.01 (0.55–1.86) | 0.980 | |
| H/L | 22 (22.2) | 1.04 (0.61–1.79) | 0.875 | 1.20 (0.67–2.16) | 0.547 | |
| H/H | 47 (30.1) | 1.51 (0.97–2.36) | 0.069 | 1.60 (0.98–2.61) | 0.061 | |
| Trend. test | 119 (23.4) | 1.17 (1.01–1.36) | 0.041 | 1.18 (1.00–1.38) | 0.047 | |
| Group 1 | 50 (19.7) | [1] | [1] | |||
| Group 2 | 22 (22.2) | 1.14 (0.69–1.88) | 0.614 | 1.20 (0.69–2.06) | 0.520 | |
| Group 3 | 47 (30.1) | 1.65 (1.11–2.45) | 0.014 | 1.59 (1.03–2.46) | 0.034 | |
| Trend. test | 119 (23.4) | 1.28 (1.05–1.57) | 0.015 | 1.26 (1.02–1.57) | 0.036 | |
| All-cause death | ||||||
| L/L | 5 (3.2) | [1] | [1] | |||
| L/H | 4 (4.0) | 1.26 (0.34–4.68) | 0.734 | 1.95 (0.40–9.56) | 0.410 | |
| H/L | 4 (4.0) | 1.28 (0.34–4.78) | 0.709 | 3.14 (0.62–15.94) | 0.168 | |
| H/H | 11 (7.1) | 2.28 (0.79–6.57) | 0.126 | 2.55 (0.62–10.49) | 0.196 | |
| Trend. test | 24 (4.7) | 1.32 (0.93–1.85) | 0.117 | 1.30 (0.87–1.94) | 0.196 | |
| Group 1 | 9 (3.5) | [1] | [1] | |||
| Group 2 | 4 (4.0) | 1.17 (0.36–3.79) | 0.797 | 1.19 (0.34–4.15) | 0.786 | |
| Group 3 | 11 (7.1) | 2.07 (0.86–5.01) | 0.104 | 1.66 (0.60–4.59) | 0.330 | |
| Trend. test | 24 (4.7) | 1.45 (0.92–2.26) | 0.107 | 1.29 (0.77–2.15) | 0.327 | |
| reMI | ||||||
| L/L | 5 (3.2) | [1] | [1] | |||
| L/H | 2 (2.0) | 0.63 (0.12–3.25) | 0.582 | 0.78 (0.15–4.20) | 0.774 | |
| H/L | 8 (8.1) | 2.62 (0.86–8.01) | 0.091 | 3.30 (1.00–10.84) | 0.050 | |
| H/H | 8 (5.1) | 1.65 (0.54–5.06) | 0.377 | 1.89 (0.58–6.16) | 0.290 | |
| Trend. test | 23 (4.5) | 1.27 (0.90–1.79) | 0.178 | 1.33 (0.93–1.91) | 0.116 | |
| Group 1 | 7 (2.8) | [1] | [1] | |||
| Group 2 | 8 (8.1) | 3.06 (1.11–8.43) | 0.031 | 3.33 (1.18–9.42) | 0.023 | |
| Group 3 | 8 (5.1) | 1.93 (0.70–5.33) | 0.204 | 2.55 (0.90–7.22) | 0.078 | |
| Trend. test | 23 (4.5) | 1.37 (0.87–2.17) | 0.174 | 1.59 (0.99–2.55) | 0.057 | |
| reHF | ||||||
| L/L | 3 (1.9) | [1] | [1] | |||
| L/H | 2 (2.0) | 1.05 (0.18–6.29) | 0.957 | 3.39 (0.19–59.02) | 0.403 | |
| H/L | 2 (2.0) | 1.06 (0.18–6.34) | 0.950 | 0.23 (0.01–6.30) | 0.384 | |
| H/H | 4 (2.6) | 1.36 (0.30–6.07) | 0.689 | 0.19 (0.02–1.94) | 0.160 | |
| Trend. test | 11 (2.2) | 1.10 (0.68–1.80) | 0.692 | 0.54 (0.26–1.09) | 0.087 | |
| Group 1 | 5 (2.0) | [1] | [1] | |||
| Group 2 | 2 (2.0) | 1.04 (0.20–5.35) | 0.964 | 0.52 (0.06–4.44) | 0.551 | |
| Group 3 | 4 (2.6) | 1.33 (0.36–4.96) | 0.670 | 0.94 (0.16–5.49) | 0.943 | |
| Trend. test | 11 (2.2) | 1.15 (0.59–2.23) | 0.677 | 0.93 (0.38–2.31) | 0.883 | |
| Stroke | ||||||
| L/L | 5 (3.2) | [1] | [1] | |||
| L/H | 2 (2.0) | 0.62 (0.12–3.20) | 0.570 | 0.54 (0.1–3.00) | 0.484 | |
| H/L | 4 (4.0) | 1.28 (0.34–4.77) | 0.713 | 1.12 (0.26–4.75) | 0.880 | |
| H/H | 7 (4.5) | 1.45 (0.46–4.56) | 0.528 | 0.93 (0.23–3.74) | 0.914 | |
| Trend. test | 18 (3.5) | 1.18 (0.80–1.74) | 0.402 | 1.02 (0.64–1.62) | 0.946 | |
| Group 1 | 7 (2.8) | [1] | [1] | |||
| Group 2 | 4 (4.0) | 1.5 (0.44–5.13) | 0.516 | 1.34 (0.38–4.75) | 0.649 | |
| Group 3 | 7 (4.5) | 1.7 (0.60–4.85) | 0.321 | 1.13 (0.35–3.71) | 0.836 | |
| Trend. test | 18 (3.5) | 1.3 (0.78–2.18) | 0.314 | 1.07 (0.60–1.91) | 0.818 | |
| Revascularization | ||||||
| L/L | 21 (13.5) | [1] | [1] | |||
| L/H | 8 (8.1) | 0.58 (0.26–1.31) | 0.190 | 0.71 (0.31–1.64) | 0.429 | |
| H/L | 11 (11.1) | 0.80 (0.39–1.66) | 0.551 | 0.91 (0.41–2.01) | 0.823 | |
| H/H | 29 (18.6) | 1.42 (0.81–2.49) | 0.221 | 1.90 (1.05–3.45) | 0.035 | |
| Trend. test | 69 (13.6) | 1.16 (0.95–1.41) | 0.152 | 1.26 (1.03–1.55) | 0.026 | |
| Group 1 | 29 (11.4) | [1] | [1] | |||
| Group 2 | 11 (11.1) | 0.96 (0.48–1.92) | 0.911 | 1.12 (0.55–2.28) | 0.764 | |
| Group 3 | 29 (18.6) | 1.70 (1.02–2.85) | 0.042 | 2.21 (1.28–3.79) | 0.004 | |
| Trend. test | 69 (13.6) | 1.31 (1.00–1.70) | 0.048 | 1.48 (1.12–1.96) | 0.005 |
Patients were divided into four groups according to TMAO levels at the enrollment (V1) and follow-up visit (V2) relative to the median of each visit point (6.7 µmol/L and 12.7 µmol/L for V1 and V2, respectively). L/L, low V1 and low V2; L/H, low V1 and high V2; H/L, high V1 and low V2; H/H, high V1 and high V2. Group1: patients with TMAO levels below the median at V1; Group 2: patients with higher levels of TMAO at V1 and subsequently lower levels at V2; Group3: patients with both higher TMAO levels at V1 and V2. HR, hazard ratio; MACE, major adverse cardiovascular event; reHF, rehospitalization caused by heart failure; reMI, recurrent myocardial infarction; TMAO, trimethylamine-N-oxide. * Adjusted for the variables with p < 0.1 in the univariable models, including age, hypertension, diabetes, peripheral artery disease, chronic kidney disease, and previous history of stroke and MI, Killip II-IV, the Global Registry of Acute Coronary Events risk score, multiple vessels disease, percutaneous coronary intervention, and the peak value of cardiac troponin I and N-terminal pro B-type natriuretic peptide during hospitalization, as well as estimated glomerular filtration rate and left ventricular ejection fraction at V2.