ArticleScientific reports2025
Trimethylamine-N-oxide (TMAO) and risk of incident cardiovascular events in the multi ethnic study of Atherosclerosis.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 4 syntheses or guidelines pooled 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
- Residual atherosclerotic cardiovascular disease risk in statin-treated patients: mechanisms, therapeutic strategies, and future directions-a scoping review.Frontiers in cardiovascular medicine · 2026Pooled 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
- A systematic review of TMAO, microRNAs, and the oral/gut microbiomes in atherosclerosis and myocardial infarction: mechanistic insights and translational opportunities.Journal of translational medicine · 2025Pooled it
- Comparative insights into the gut-heart axis: cross-species and cross-population perspectives.Gut microbes · 2026Review
- [Correlation between trimethylamine-N-oxide and cardiovascular metabolic markers].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
- Gut microecology and cardiovascular disease: core pathogenic mechanisms and clinical intervention strategies.Folia microbiologica · 2026Review
- From Fecal Microbial Potential to Circulating Trimethylamine N-oxide and Cardiovascular Events: A Narrative Review.Cureus · 2026Review
- Human biomarker navigator.iMeta · 2026Review
- TMAO Correlates with Transcriptomic Signatures of Leukocyte Activation and Systemic Inflammation Following Burn Injury.Journal of burn care & research : official publication of the American Burn Association · 2026Article
- The Hidden Burden of Water-Binding Additives in Meat Products: Biochemical, Clinical, and Psychosocial Implications.Molecular nutrition & food research · 2026Review
- Targeting Uremic Toxins in Chronic Kidney Disease: Current Challenges and Emerging Therapeutic Strategies.Toxins · 2026Review
- Microbiota-derived metabolites and cardiovascular implications in Inflammatory Bowel Disease (IBD).Molecular medicine (Cambridge, Mass.) · 2026Review
- The Importance of Liver-Lung Communication in Pulmonary Vascular Diseases.Comprehensive Physiology · 2026Review
- Metabolic Analysis of Human Retinal Pigment Epithelium and Choroid Tissue in Aging and Macular Degeneration.bioRxiv : the preprint server for biology · 2026Article
- Biomarkers for Screening and Diagnosis of Heart Failure in Cardiovascular-Kidney-Metabolic Syndrome: A Narrative Review.International journal of molecular sciences · 2026Review
- Punicalagin is the key pomegranate polyphenol inhibiting gut microbial trimethylamine (TMA) production from L-carnitine in anFood & function · 2026Article
- Soy and the gut microbiome: a bi-directional relationship shaping nutrition and health.European journal of nutrition · 2026Review
- The gut-heart axis in coronary artery disease: a scoping and narrative review of sex-based microbial and metabolic disparities.Biology of sex differences · 2026Article
- Gut microbiota dysbiosis-induced chronic inflammation as a driver of atherosclerosis: cellular crosstalk and host-microbe interactions.Frontiers in cellular and infection microbiology · 2026Review
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
Trimethylamine-N-oxide (TMAO) is a gut microbiome-derived metabolite of choline, L-carnitine and lecithin, abundant in animal source foods. In experimental models, higher blood TMAO levels enhance atherosclerotic cardiovascular disease (ASCVD). However in humans, most prior studies have evaluated high risk or secondary prevention populations, and no studies have investigated relationships in a diverse, multi-ethnic population. We evaluated 6,767 US adults free of ASCVD at baseline in the community-based Multi-Ethnic Study of Atherosclerosis (MESA), including 38% identifying as White; 28%, as Black; 22%, as Hispanic; and 12%, as Chinese adults. Plasma TMAO was measured serially at baseline and 5-years, and its time-varying association with incident ASCVD determined using Cox proportional hazards. Multivariate analyses adjusted for time-varying demographics, lifestyle factors, medical history, lipid measures, antibiotic use and dietary habits. During median 11.3 years follow-up, 852 ASCVD events occurred. After multivariate adjustment, TMAO associated with higher risk of ASCVD in a dose-dependent fashion, with hazard ratios across quintiles of 1.02, 1.17, 1.23, and 1.33 (95% CI 1.02, 1.74), respectively, compared to the lowest quintile (P-trend = 0.01). Risk appeared possibly larger among Hispanic and Chinese adults; and among individuals with lower baseline renal function; although these interactions did not achieve statistical significance. Plasma concentrations of TMAO associated with higher risk of incident ASCVD in this multi-ethnic US cohort, supporting a need to test dietary and pharmacologic interventions targeting the diet-microbiome axis for potential cardiovascular risk prevention in diverse populations.
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