ArticleThe American journal of cardiology2022
Relation of Statin Use to Gut Microbial Trimethylamine N-Oxide and Cardiovascular Risk.
Article in The American journal of cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
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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
20 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Effects of probiotics combined with statins on blood lipids, TMAO, and inflammatory and oxidative stress markers in patients with atherosclerosis: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- The Effects of Statin Therapy on Circulating Levels of Trimethylamine N-oxide: A Systematic Review and Meta-analysis.Current medicinal chemistry · 2025Pooled it
- Prognostic Value of Serum TMAO Measurement in Patients with STEMI: A Systematic Literature Review.Current vascular pharmacology · 2025Pooled it
- Effect of nuts on lipid profile and inflammatory biomarkers in atherosclerotic cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials.European journal of nutrition · 2024Pooled it
- Review
- Gut microbe-generated metabolite trimethylamine N-oxide and risk of abdominal aortic aneurysm: a cohort study.European heart journal · 2026Article
- Article
- Decoding the gut microbiota-mitochondrial-inflammasome axis in cardiovascular disease.Molecular and cellular biochemistry · 2026Review
- Gut microbiota-derived TMAO drives the kidney-bone-vascular axis in chronic kidney disease complications.Renal failure · 2025Review
- From Gut to Heart: Targeting Trimethylamine N-Oxide as a Novel Strategy in Heart Failure Management.Biomolecules · 2025Review
- Gut-Heart Axis: The Role of Gut Microbiota and Metabolites in Heart Failure.Circulation research · 2025Review
- Trimethylamine N-Oxide as a Biomarker for Left Ventricular Diastolic Dysfunction and Functional Remodeling After STEMI.International journal of molecular sciences · 2025Observational
- Trimethylamine-N-Oxide (TMAO) as a Rising-Star Metabolite: Implications for Human Health.Metabolites · 2025Review
- Decoding TMAO in the Gut-Organ Axis: From Biomarkers and Cell Death Mechanisms to Therapeutic Horizons.Drug design, development and therapy · 2025Review
- Gut Microbiota and Metabolic Alterations Associated with Heart Failure and Coronary Artery Disease.International journal of molecular sciences · 2024Article
- Targeting the Gut Microbiome to Treat Cardiometabolic Disease.Current atherosclerosis reports · 2024Review
- The Prognostic Biomarkers of Plasma Trimethylamine N-Oxide and Short-Chain Fatty Acids for Recanalization Therapy in Acute Ischemic Stroke.International journal of molecular sciences · 2023Article
- Neurodegenerative and Neurodevelopmental Diseases and the Gut-Brain Axis: The Potential of Therapeutic Targeting of the Microbiome.International journal of molecular sciences · 2023Review
- Meta-analysis of the effect of probiotics or synbiotics on the risk factors in patients with coronary artery disease.Frontiers in cardiovascular medicine · 2023Review
- Gender-specific association between the regular use of statins and the risk of irritable bowel syndrome: A population-based prospective cohort study.Frontiers in pharmacology · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Accumulating evidence suggests that statins can influence the microbiota. We investigated the effects of statin therapy on circulating levels of atherogenic gut microbial metabolite, trimethylamine N-oxide (TMAO), and subsequent clinical outcomes. We examined the effects of statin use on plasma TMAO in patients who are statin-naive with dyslipidemia previously enrolled in 2 intervention studies, International Medical Innovations (n = 79) and Advances in Atorvastatin Research Group (n = 27) in a post hoc analysis. A propensity score matching model stratified by statin use was used to validate the associations between statin use, plasma TMAO, and major adverse cardiovascular events across 4,007 patients who underwent elective coronary angiography. In the International Medical Innovations cohort, at 4 weeks, statin use was associated with decreased plasma TMAO (p = 0.03) and a return to baseline after statin discontinuation. In both intervention cohorts, patients with higher baseline TMAO (predefined cutoff 6.18 μM) showed significant reductions in TMAO (all p <0.05). Propensity score matching on statin use (1,196 patient-pairs) revealed lower plasma TMAO (p = 0.002) with statin use. An adjusted cox regression model including statin use, TMAO, and cholesterol showed preserved association of statin use and TMAO but not cholesterol with major adverse cardiovascular events (p = 0.005, p <0.001, p = 0.24, respectively). A likelihood ratio test showed improved model fit (p <0.001) with the addition of TMAO. In conclusion, our findings demonstrate that statin therapy significantly decreases plasma TMAO levels, suggesting the potential contribution of a statin-mediated reduction of TMAO production in cardiovascular benefits in addition to improved lipid profile and attenuated inflammation.
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Registered trials
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