Plasma trimethylamine N-oxide is associated with vulnerable plaque characteristics in CAD patients as assessed by optical coherence tomography
Plasma trimethylamine N-oxide is associated with vulnerable plaque characteristics in CAD patients as assessed by optical coherence tomography
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通过光学相干断层扫描评估，血浆三甲胺 N-氧化物与 CAD 患者的易损斑块特征相关
DOI：
10.1016/j.ijcard.2018.04.126
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发表时间：
2018-08-15
影响因子：
3.5
通讯作者：
Yu, Bo
中科院分区：
文献类型：
--
作者：
Liu, Xinxin;Xie, Zulong;Yu, Bo
背景：斑块易损性表明心血管事件的风险。在本研究中，我们试图分析三甲胺N-氧化物（TMAO），肠道微生物群的代谢产物从饮食磷脂酰胆碱，易损斑块的特点与冠心病（CAD）患者之间的关系。方法：180例非罪犯斑块从90例ACS或稳定型心绞痛患者进行了光学相干断层扫描（OCT）进行了评估。结果：根据血浆中位TMAO水平（114.73 μ g/L）将患者分为高TMAO组和低TMAO组。高TMAO组的非罪犯斑块显示出较薄的纤维帽厚度（FCT）（65.97 ± 25.89 vs. 93.0 ± 28.28 μ m，P < 0.001），微血管频率较高（75.6%对31.1%，P < 0.001，每例患者）和增加的薄帽纤维粥样硬化（TCFA）的发生率（69.2%对18.4%，P < 0.001，每例患者）。TMAO水平与FCT呈负相关（r =-0.418，P < 0.001）。多元回归分析结果表明，TMAO（OR：7.455，95% CI：2.753-20.189，P < 0.001）与TCFA有显著相关性，其临界值为118.34 μ g/L，预测TCFA患病率的特异性为72.6%，敏感性为79.5%。总之，这些结果表明，TMAO水平与TCFA的发病率显着相关。通过非侵入性手段获得的新生物标志物，如TMAO，为改善CAD患者的风险分层和临床管理提供了可能。(C)2018爱思唯尔B. V.保留所有权利。
Background: Plaque vulnerability indicates the risk of a cardiovascular event. In the present study, we sought to analyze the relationship between trimethylamine N-oxide (TMAO), a gut microbiota metabolite from dietary phosphatidylcholine, and vulnerable plaque characteristics in patients with coronary artery disease (CAD).Methods: One hundred eighty non-culprit plaques from 90 patients with ACS or with stable angina were assessed by optical coherence tomography (OCT). The plasma TMAO levels were measured using rapid resolution liquid chromatography quadrupole time-of-flight mass spectrometry (RRLC-QTOF/MS).Results: Patients were divided into two groups (high TMAO group and low TMAO group) according to the median plasma TMAO level (114.73 mu g/L). The non-culprit plaques in the high TMAO group exhibited a thinner fibrous cap thickness (FCT) (65.97 +/- 25.89 vs. 93.0 +/- 28.28 mu m, P < 0.001), higher frequency of microvessels (75.6% vs. 31.1%, P < 0.001, per-patient) and increased incidence of thin-cap fibroatheroma (TCFA) (69.2% vs. 18.4%, P < 0.001, per-patient) compared with the low TMAO group. Moreover, the level of TMAO was negatively associated with FCT (r = -0.418, P < 0.001). Furthermore, multivariate regression analysis results showed that TMAO (OR: 7.455, 95% CI: 2.753-20.189, P < 0.001) had a significant association with TCFA, with a cut-off point of 118.34 mu g/L, specificity of 72.6% and sensitivity of 79.5% in predicting the prevalence of TCFA.Conclusions: In conclusion, these findings suggest that the level of TMAO is significantly correlated with the incidence of TCFA. New biomarkers acquired through non-invasive means, such as TMAO, offer the potential to improve risk stratification and clinical management in patients with CAD. (C) 2018 Elsevier B.V. All rights reserved.