ArticleJournal of the American College of Cardiology2020
Long-Term Changes in Gut Microbial Metabolite Trimethylamine N-Oxide and Coronary Heart Disease Risk.
Article in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 4 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
89 citing papers in PubMed, 4 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- Plasma trimethylamine N-oxide and arteriosclerotic cardiovascular disease: a systematic review and meta-analysis of case-control studies.Frontiers in cardiovascular medicine · 2026Pooled it
- The Effect of Red Meat Consumption on Circulating, Urinary, and Fecal Trimethylamine-N-Oxide: A Systematic Review and Narrative Synthesis of Randomized Controlled Trials.Advances in nutrition (Bethesda, Md.) · 2025Pooled it
- The Effects of Statin Therapy on Circulating Levels of Trimethylamine N-oxide: A Systematic Review and Meta-analysis.Current medicinal chemistry · 2025Pooled it
- Gut microbiota-derived metabolite trimethylamine-N-oxide and multiple health outcomes: an umbrella review and updated meta-analysis.The American journal of clinical nutrition · 2022Pooled it
- Effect of Varying Quantities of Lean Beef as Part of a Mediterranean-Style Dietary Pattern on Gut Microbiota and Plasma, Fecal, and Urinary Metabolites: A Randomized Crossover Controlled Feeding Trial.Journal of the American Heart Association · 2025Trial
- Effect of acarbose and vildagliptin on plasma trimethylamine N-oxide levels in patients with type 2 diabetes mellitus: a 6-month, two-arm randomized controlled trial.Frontiers in endocrinology · 2025Trial
- Effects of a diet based on the Dietary Guidelines on vascular health and TMAO in women with cardiometabolic risk factors.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2022Trial
- Effects of a Vegetarian Diet on Cardiometabolic Risk Factors, Gut Microbiota, and Plasma Metabolome in Subjects With Ischemic Heart Disease: A Randomized, Crossover Study.Journal of the American Heart Association · 2020Trial
- Elevated plasma TMAO levels associated with all-cause mortality in CAD patients in South China.BMC cardiovascular disorders · 2026Observational
- Associations of trimethylamine N-oxide and its precursors with hypertensive disorders of pregnancy, its subtypes and blood pressure in the offspring: findings from the Shanghai Birth Cohort.BMC pregnancy and childbirth · 2026Article
- Clinical Implications of the 2025-2030 Dietary Guidelines for Americans for Diabetes and Prediabetes Management.Journal of diabetes · 2026Article
- Personalized Nutrition Through the Gut Microbiome in Metabolic Syndrome and Related Comorbidities.Nutrients · 2026Review
- Nanobiosensors: A Potential Tool to Decipher the Nexus Between SARS-CoV-2 Infection and Gut Dysbiosis.Sensors (Basel, Switzerland) · 2026Review
- Traditional Chinese medicine-based modulation of gut microbiota in coronary heart disease: probiotic synergy and translational perspectives.Frontiers in cardiovascular medicine · 2026Review
- Gut microbiota-induced elevation of succinate exacerbates diabetic myocardial ischemia/reperfusion injury by promoting macrophage polarization.Frontiers in immunology · 2026Article
- Establishment of a mouse model of TMAO-induced cardiac injury and application of MICT intervention.Animal models and experimental medicine · 2026Article
- Trimethylamine-N-oxide promotes fibrotic activation of quiescent valvular interstitial cells via endoplasmic reticulum stress.Scientific reports · 2025Article
- Interplay Among Gut Microbiota-Derived TMAO, Autonomic Nervous System Dysfunction, and Heart Failure Progression.International journal of molecular sciences · 2025Review
- Assessing the impact of bariatric surgery on cardiovascular risk in type 2 diabetes: a systematic review and meta-analysis using OMICs data.Diabetology & metabolic syndrome · 2025Review
- Trimethylamine N-Oxide Linking Gut Microbiota to Cardiocerebral Disease Is a Novel Biomarker for Stroke Subtypes With Mixed Etiology: A Prospective Cohort Study.CNS neuroscience & therapeutics · 2025Article
29 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundA gut-microbial metabolite, trimethylamine N-oxide (TMAO), has been associated with coronary atherosclerotic burden. No previous prospective study has addressed associations of long-term changes in TMAO with coronary heart disease (CHD) incidence.
objectivesThe purpose of this study was to investigate whether 10-year changes in plasma TMAO levels were significantly associated with CHD incidence.
methodsThis prospective nested case-control study included 760 healthy women at baseline. Plasma TMAO levels were measured both at the first (1989 to 1990) and the second (2000 to 2002) blood collections; 10-year changes (Δ) in TMAO were calculated. Incident cases of CHD (n = 380) were identified after the second blood collection through 2016 and were matched to controls (n = 380).
resultsRegardless of the initial TMAO levels, 10-year increases in TMAO from the first to second blood collection were significantly associated with an increased risk of CHD (relative risk [RR] in the top tertile: 1.58 [95% confidence interval (CI): 1.05 to 2.38]; RR per 1-SD increment: 1.33 [95% CI: 1.06 to 1.67]). Participants with elevated TMAO levels (the top tertile) at both time points showed the highest RR of 1.79 (95% CI: 1.08 to 2.96) for CHD as compared with those with consistently low TMAO levels. Further, we found that the ΔTMAO-CHD relationship was strengthened by unhealthy dietary patterns (assessed by the Alternate Healthy Eating Index) and was attenuated by healthy dietary patterns (p interaction = 0.008).
conclusionsLong-term increases in TMAO were associated with higher CHD risk, and repeated assessment of TMAO over 10 years improved the identification of people with a higher risk of CHD. Diet may modify the associations of ΔTMAO with CHD 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.