Patients with acute HF show high levels of metabolite found in red meat
Patients with acute HF tend to have high levels of a metabolite for which red meat is a significant dietary source, and high levels of it are associated with poor prognosis, according to recent study findings.
Researchers examined whether the gut-derived metabolite trimethylamine N-oxide (TMAO), which has been associated with chronic HF, is associated with acute HF and affects prognosis.
According to the study background, red meat is a major source of L-carnitine, from which TMAO is formed after being broken down by gut bacteria.
Toru Suzuki, MD, PhD, and colleagues analyzed plasma samples from 972 patients (mean age, 78 years; 61% men) admitted to the hospital with acute HF. They used liquid chromatography-mass spectrometry to measure TMAO concentration, and analyzed whether circulating TMAO level was associated with in-hospital mortality, all-cause mortality and death or rehospitalization for HF at 1 year.
Suzuki, from the department of cardiovascular sciences and the cardiovascular biomedical research unit, University of Leicester, England, and colleagues found that TMAO was a univariate predictor of death at 1 year (HR = 1.35; 95% CI, 1.21-1.51) and death or HF at 1 year (HR = 1.33; 95% CI, 1.2-1.46), and that it improved risk prediction for in-hospital mortality over existing clinical scorings (OR 1.13; P .014).
When adjusted for cardiac risk factors, TMAO remained an independent predictor of death and death or HF at 1 year (HR 1.16; P .037), but the findings were attenuated when adjusted for renal function indicators such as estimated glomerular filtration rate and blood urea, “possibly due to multicollinearity,” the researchers wrote.
When patients were stratified into tertiles by TMAO level, there was increased risk for poor outcomes at 1 year with increased TMAO level (OR 1.61; P .004), and improved outcome prediction when both TMAO and N-terminal pro–B-type natriuretic peptide were elevated (OR 2.15; P .007), they found.
“Our study shows that higher levels of TMAO ... is associated with poorer outcomes associated with acute [HF],” Suzuki said in a press release. “This metabolic pathway provides a possible link between how red meat is associated with heart disease.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.