ArticlePloS one2012
Betaine and secondary events in an acute coronary syndrome cohort.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Association of Gut Microbiota-Related Metabolites and Type 2 Diabetes in Two Puerto Rican Cohorts.Nutrients · 2024Pooled it
- Marked Changes in One-Carbon Metabolism on a Low-Carbohydrate High-Fat Diet: A Randomized Controlled Trial (CARBFUNC).The Journal of nutrition · 2026Trial
- Plasma choline and betaine and neurological function trajectory after acute ischemic stroke.BMC neurology · 2026Trial
- Two methods for assessment of choline status in a randomized crossover study with varying dietary choline intake in people: isotope dilution MS of plasma and in vivo single-voxel magnetic resonance spectroscopy of liver.The American journal of clinical nutrition · 2021Trial
- Metabolic Effects of Betaine: A Randomized Clinical Trial of Betaine Supplementation in Prediabetes.The Journal of clinical endocrinology and metabolism · 2018Trial
- Assessment of urinary betaine as a marker of diabetes mellitus in cardiovascular patients.PloS one · 2013Trial
- Trimethylamine N-oxide and related metabolites may regulate DNA methylation and trigger cardiovascular disease.Clinical epigenetics · 2026Article
- Urea, TMAO, betaine and other osmolytes as endogenous diuretics in heart failure and hypertension.Heart failure reviews · 2025Review
- Exercise-mimicking effects of betaine in chronic disease prevention and management.Frontiers in nutrition · 2025Review
- Effects of choline metabolite-trimethylamine N-oxide on immunometabolism in inflammatory bowel disease.Frontiers in immunology · 2025Review
- Targeted metabolomic profiling of acute ST-segment elevation myocardial infarction.Scientific reports · 2024Article
- Review
- Differential implications of gut-related metabolites on outcomes between heart failure and myocardial infarction.European journal of preventive cardiology · 2024Article
- Metabolomics Profiling Predicts Ventricular Arrhythmia in Patients with an Implantable Cardioverter Defibrillator.Journal of cardiovascular translational research · 2024Article
- Combined Metabolipidomic and Machine Learning Approach in a Rat Model of Stroke Reveals a Deleterious Impact of Brain Injury on Heart Metabolism.International journal of molecular sciences · 2023Article
- Healthy Nordic diet and associations with plasma concentrations of metabolites in the choline oxidation pathway: a cross-sectional study from Northern Sweden.Nutrition journal · 2023Article
- Serum Homocysteine and Vascular Calcification: Advances in Mechanisms, Related Diseases, and Nutrition.Korean journal of family medicine · 2022Article
- Effects of Gut Microbiota and Metabolites on Heart Failure and Its Risk Factors: A Two-Sample Mendelian Randomization Study.Frontiers in nutrition · 2022Article
- High Betaine and Dynamic Increase of Betaine Levels Are Both Associated With Poor Prognosis of Patients With Pulmonary Hypertension.Frontiers in cardiovascular medicine · 2022Article
- Implications of trimethylamine N-oxide (TMAO) and Betaine in Human Health: Beyond Being Osmoprotective Compounds.Frontiers in molecular biosciences · 2022Review
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBetaine insufficiency is associated with unfavourable vascular risk profiles in metabolic syndrome patients. We investigated associations between betaine insufficiency and secondary events in acute coronary syndrome patients.
methodsPlasma (531) and urine (415) samples were collected four months after discharge following an acute coronary event. Death (34), secondary acute myocardial infarction (MI) (70) and hospital admission for heart failure (45) events were recorded over a median follow-up of 832 days. PRINCIPAL
findingsThe highest and lowest quintiles of urinary betaine excretion associated with risk of heart failure (p = 0.0046, p = 0.013 compared with middle 60%) but not with subsequent acute MI. The lowest quintile of plasma betaine was associated with subsequent acute MI (p = 0.014), and the top quintile plasma betaine with heart failure (p = 0.043), especially in patients with diabetes (p<0.001). Top quintile plasma concentrations of dimethylglycine (betaine metabolite) and top quintile plasma homocysteine both associated with all three outcomes, acute MI (p = 0.004, <0.001), heart failure (p = 0.027, p<0.001) and survival (p<0.001, p<0.001). High homocysteine was associated with high or low betaine excretion in >60% of these subjects (p = 0.017). Median NT-proBNP concentrations were lowest in the middle quintile of plasma betaine concentration (p = 0.002).
conclusionsBetaine insufficiency indicates increased risk of secondary heart failure and acute MI. Its association with elevated homocysteine may partly explain the disappointing results of folate supplementation. In some patients, especially with diabetes, elevated plasma betaine also indicates increased risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.