ArticleJournal of the American Heart Association2020
Gut Microbiota-Dependent Trimethylamine N-oxide and Cardiovascular Outcomes in Patients With Prior Myocardial Infarction: A Nested Case Control Study From the PEGASUS-TIMI 54 Trial.
Article in Journal of the American Heart Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 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.
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Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Gut Microbiota and Its Metabolites in the Prognosis of Coronary Heart Disease: A Systematic Review and Mechanistic Insights.Cardiovascular drugs and therapy · 2026Pooled it
- Plasma trimethylamine N-oxide and arteriosclerotic cardiovascular disease: a systematic review and meta-analysis of case-control studies.Frontiers in cardiovascular medicine · 2026Pooled it
- Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled 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
- Trimethylamine N-oxide and major adverse cardiac and cerebrovascular events: results of umbrella review and meta-analysis.Nutrition & metabolism · 2026Article
- Gut microbiota‑derived metabolites in cardiovascular disease: Focus on trimethylamine N‑oxide, short‑chain fatty acids and bile acids (Review).Molecular medicine reports · 2026Review
- Residual cardiovascular risk in coronary artery disease: from pathophysiology to established and novel therapies.Nature reviews. Cardiology · 2026Review
- Intervening at the microbial crossroads: targeting inflammation across the oral-gut-reproductive microbiome crosstalk in atherosclerosis.Antonie van Leeuwenhoek · 2026Review
- Microbiome-Associated Drug Response Variability in Heart Failure Treatment.Life (Basel, Switzerland) · 2026Review
- Article
- Modulation of gut microFLORA with rifaximin to reduce high platelet reactivity in post-ACS patients on ticagrelor: rationale and design of the FLORA-ACS study.Cardiology journal · 2026Article
- How the Microbiome Drives Cardiovascular Disease.The Surgical clinics of North America · 2025Review
- Gastrointestinal Dysfunction and Dysbiosis in Ischemic Stroke: Opportunities for Therapeutic Intervention.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Microbiome-Derived Trimethylamine N-Oxide (TMAO) as a Multifaceted Biomarker in Cardiovascular Disease: Challenges and Opportunities.International journal of molecular sciences · 2024Review
- Duality of Branched-Chain Amino Acids in Chronic Cardiovascular Disease: Potential Biomarkers versus Active Pathophysiological Promoters.Nutrients · 2024Review
- The Mediterranean Diet, Its Microbiome Connections, and Cardiovascular Health: A Narrative Review.International journal of molecular sciences · 2024Review
- Gut Microbiota in Ischemic Stroke: Role of Gut Bacteria-Derived Metabolites.Translational stroke research · 2023Review
- Natural compounds regulate the PI3K/Akt/GSK3β pathway in myocardial ischemia-reperfusion injury.Cell cycle (Georgetown, Tex.) · 2023Article
- Secondary Cardiovascular Prevention after Acute Coronary Syndrome: Emerging Risk Factors and Novel Therapeutic Targets.Journal of clinical medicine · 2023Review
- 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
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Authors and funding
13 authors at 8 institutions in 4 countries.
Funding
Abstract
Background Trimethylamine N-oxide (TMAO) may have prothrombotic properties. We examined the association of TMAO quartiles with major adverse cardiovascular events (MACE) and the effect of TMAO on the efficacy of ticagrelor. Methods and Results PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin - Thrombolysis in Myocardial Infarction 54) randomized patients with prior myocardial infarction to ticagrelor or placebo (median follow-up 33 months). Baseline plasma concentrations of TMAO were measured in a nested case-control study of 597 cases with cardiovascular death, myocardial infarction, or stroke (MACE) and 1206 controls matched for age, sex, and estimated glomerular filtration rate [eGFR]. Odds ratios (OR) were used for the association between TMAO quartiles and MACE, adjusting for baseline clinical characteristics (age, sex, eGFR, region, body mass index, hypertension, hypercholesterolemia, diabetes mellitus, smoking, peripheral artery disease, index event, aspirin dosage and treatment arm), and cardiovascular biomarkers (hs-TnT [high-sensitivity troponin T], hs-CRP [high-sensitivity C-reactive protein], NT-proBNP [N-terminal-pro-B-type natriuretic peptide]). Higher TMAO quartiles were associated with risk of MACE (OR for quartile 4 versus quartile 1, 1.43, 95% CI, 1.06-1.93,
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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.