Georgios Vakadaris, Theofanis Korovesis, Charalampos Balomenakis, Andreas S Papazoglou, Stavros P Papadakos, Ioannis Karniadakis, Dimitrios V Moysidis, Konstantinos Arvanitakis, Georgios Germanidis, Emmanouil S Brilakis, Anastasios Milkas
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引用次数: 0
摘要
背景：肠道微生物来源的代谢物三甲胺- n -氧化物（TMAO）越来越被认为是心血管疾病潜在的新型预后生物标志物。我们的研究工作旨在探讨TMAO测量在STEMI患者中的潜在效用。方法：我们在PubMed上进行了系统的文献检索，从开始到2024年2月1日，以确定所有研究血浆TMAO水平与STEMI患者疾病复杂性或临床结局之间的关系。结果：共纳入8项前瞻性队列研究，共纳入2378例STEMI患者。其中三项研究仅提供了住院证据（即TMAO水平升高的患者发生更严重冠状动脉疾病、斑块破裂和斑块愈合的几率增加）。四项研究考察了STEMI后随访10-12个月后TMAO的长期预后价值（即TMAO水平升高的患者发生不良心血管事件的风险增加），而一项研究提供了住院和中期预后的数据，表明STEMI后4个月TMAO水平升高的患者梗死面积较大。结论：较高的TMAO水平与STEMI患者较高的高危冠状动脉斑块特征患病率以及较差的住院和随访结果相关。调节饮食依赖性TMAO水平是否能改善这些患者的临床结果还需要进一步的研究。注册编号：[(OSF): https://doi.org/10.17605/OSF.IO/WNG8V]。
Prognostic Value of Serum TMAO Measurement in Patients with STEMI: A Systematic Literature Review.
Background: Gut microbiota-derived metabolite Trimethylamine-N-oxide (TMAO) is increasingly recognized as a potential novel prognostic biomarker for cardiovascular disease. Our research work aimed to investigate the potential utility of TMAO measurement in patients with STelevation Myocardial Infarction (STEMI).
Methods: We performed a systematic literature search in PubMed from inception to the 1st of February 2024 to identify all studies examining the association between plasma TMAO levels and disease complexity or clinical outcomes in STEMI patients.
Results: A total of eight prospective cohort studies were included, encompassing a total of 2,378 STEMI patients. Three of the studies provided only in-hospital evidence (i.e., increased odds for more severe coronary artery disease, plaque rupture, and plaque healing in patients with increased TMAO levels). Four studies examined the long-term prognostic value of TMAO after 10-12 months of follow-up post-STEMI (i.e., increased risk of adverse cardiovascular events in patients with increased TMAO levels), while one study provided data for both in-hospital and mid-term prognosis, indicating that 4-months after STEMI patients with greater TMAO elevation had larger infarct size.
Conclusion: Higher TMAO levels were associated with a greater prevalence of high-risk coronary plaque characteristics and worse in-hospital and follow-up outcomes in STEMI patients. Further study is needed on whether modulating the diet-dependent TMAO levels could improve clinical outcomes in these patients.
期刊介绍：
Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research.
Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).
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