ArticleEuropean heart journal2019
Trimethyllysine, a trimethylamine N-oxide precursor, provides near- and long-term prognostic value in patients presenting with acute coronary syndromes.
Article in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
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53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- Cardiovascular Disease in the Context of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Comprehensive Narrative Review.International journal of molecular sciences · 2025Pooled it
- At the Intersection of Gut Microbiome and Stroke: A Systematic Review of the Literature.Frontiers in neurology · 2021Pooled it
- Trial
- Quantifying the inclusion of cardiovascular research into clinical guidelines.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Integrating host-microbiome multi-omics with machine learning: methods, benchmarks, and translational applications.Science China. Life sciences · 2026Review
- Interaction of plant-derived metabolites and rhizobiome functions enhances drought stress tolerance.Genome biology · 2025Article
- Trajectories of cardiovascular ageing-from molecular mechanisms to clinical implementation.Cardiovascular research · 2025Review
- Elevated plasma trimethyllysine is associated with incident atrial fibrillation.American journal of preventive cardiology · 2025Article
- Xylitol is prothrombotic and associated with cardiovascular risk.European heart journal · 2024Article
- Risk for cardiovascular disease development in rheumatoid arthritis.BMC cardiovascular disorders · 2024Article
- Insights from metagenomics into gut microbiome associated with acute coronary syndrome therapy.Frontiers in microbiology · 2024Article
- Improved Risk Prediction of Acute Myocardial Infarction in Patients With Stable Coronary Artery Disease Using an Amino Acid-Assisted Model.Cardiovascular therapeutics · 2024Article
- Serum trimethylamine N-oxide levels among coronary artery disease and acute coronary syndrome patients: a systematic review and meta-analysis.Annals of medicine and surgery (2012) · 2023Review
- Alterations in gut microbiota and host transcriptome of patients with coronary artery disease.BMC microbiology · 2023Article
- [Statin intolerance-Statin tolerance].Innere Medizin (Heidelberg, Germany) · 2023Review
- Neither Trimethylamine-N-Oxide nor Trimethyllysine Is Associated with Atherosclerosis: A Cross-Sectional Study in Older Japanese Adults.Nutrients · 2023Article
- Connections between serum Trimethylamine N-Oxide (TMAO), a gut-derived metabolite, and vascular biomarkers evaluating arterial stiffness and subclinical atherosclerosis in children with obesity.Frontiers in endocrinology · 2023Article
- Mechanisms, therapeutic implications, and methodological challenges of gut microbiota and cardiovascular diseases: a position paper by the ESC Working Group on Coronary Pathophysiology and Microcirculation.Cardiovascular research · 2022Review
- Higher circulating Trimethylamine N-oxide levels are associated with worse severity and prognosis in pulmonary hypertension: a cohort study.Respiratory research · 2022Article
- Association of Systemic Trimethyllysine With Heart Failure With Preserved Ejection Fraction and Cardiovascular Events.The Journal of clinical endocrinology and metabolism · 2022Article
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19 authors at 8 institutions in 3 countries.
Funding
Abstract
aimsTrimethyllysine (TML) serves as a nutrient precursor of the gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) and is associated with incident cardiovascular (CV) events in stable subjects. We examined the relationship between plasma TML levels and incident CV events in patients presenting with acute coronary syndromes (ACS). METHODS AND
resultsPlasma levels of TML were quantified in two independent cohorts using mass spectrometry, and its relationship with CV events was investigated. In a Cleveland Cohort (N = 530), comprised of patients presenting to the emergency department with chest pain and suspected ACS, TML was associated with major adverse cardiac events (MACE, myocardial infarction, stroke, need for revascularization, or all-cause mortality) over both 30 days [3rd tertile (T3), adjusted odds ratio (OR) 1.77, 95% confidence interval (CI) 1.04-3.01; P < 0.05] and 6 months (T3, adjusted OR 1.95, 95% CI 1.15-3.32; P < 0.05) of follow-up independent of traditional CV risk factors and indices of renal function. Elevated TML levels were also associated with incident long-term (7-year) all-cause mortality [T3, adjusted hazard ratio (HR) 2.52, 95% CI 1.50-4.24; P < 0.001], and MACE even amongst patients persistently negative for cardiac Troponin T at presentation (e.g. 30-day MACE, T3, adjusted OR 4.49, 95% CI 2.06-9.79; P < 0.001). Trimethyllysine in combination with TMAO showed additive significance for near- and long-term CV events, including patients with 'negative' high-sensitivity Troponin T levels. In a multicentre Swiss Cohort (N = 1683) comprised of ACS patients, similar associations between TML and incident 1-year adverse cardiac risks were observed (e.g. mortality, adjusted T3 HR 2.74, 95% CI 1.28-5.85; P < 0.05; and MACE, adjusted T3 HR 1.55, 95% CI 1.04-2.31; P < 0.05).
conclusionPlasma TML levels, alone and together with TMAO, are associated with both near- and long-term CV events in patients with chest pain and ACS.
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