SynthesisFrontiers in cardiovascular medicine2026
Gut microbiota-derived trimethylamine N-oxide and the incidence and recurrence of atrial fibrillation: a systematic review and meta-analysis.
Synthesis in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
4 authors.
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Abstract
Objective: To quantify the association between circulating trimethylamine N-oxide (TMAO) and atrial fibrillation (AF) risk and determine how this association is modified by clinical background. Methods: We performed a systematic review and meta-analysis by searching PubMed, Web of Science, EMBASE, Scopus, and ProQuest for studies published up to April 2026. Studies reporting quantitative associations between circulating TMAO levels and AF outcomes were included. Meta-analytic pooling of odds ratios (ORs) and hazard ratios (HRs) was conducted using R packages meta under random-effects models. Pre-specified subgroup analyses were performed by clinical setting and AF outcome type. Heterogeneity was quantified using I Result: Of the 15 included studies, 9 were included in the quantitative meta-analysis, comprising 8 odds-ratio and 2 hazard-ratio studies with one overlapping. The random-effects meta-analysis of the eight odds ratio studies demonstrated a significant positive association between TMAO and AF (pooled OR 1. 35, 95% CI 1. 15-1. 59, Conclusion: Circulating TMAO is significantly associated with increased AF risk, with the magnitude of risk markedly augmented in the postoperative cardiac surgery setting,positioning TMAO as a context-dependent biomarker that requires interventional evidence before being considered a target for gut microbiota-directed interventions.
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