Hochstrasser, Seraina R. and Metzger, Kerstin and Vincent, Alessia M. and Becker, Christoph and Keller, Annalena K. J. and Beck, Katharina and Perrig, Sebastian and Tisljar, Kai and Sutter, Raoul and Schuetz, Philipp and Bernasconi, Luca and Neyer, Peter and Marsch, Stephan and Hunziker, Sabina. (2020) Trimethylamine-N-oxide (TMAO) predicts short- and long-term mortality and poor neurological outcome in out-of-hospital cardiac arrest patients. Clinical Chemistry and Laboratory Medicine, 59 (2). pp. 393-402.
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Official URL: https://edoc.unibas.ch/78315/
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Abstract
Objectives Prior research found the gut microbiota-dependent and pro-atherogenic molecule trimethylamine-N-oxide (TMAO) to be associated with cardiovascular events as well as all-cause mortality in different patient populations with cardiovascular disease. Our aim was to investigate the prognostic value of TMAO regarding clinical outcomes in patients after out-of-hospital cardiac arrest (OHCA). Methods We included consecutive OHCA patients upon intensive care unit admission into this prospective observational study between October 2012 and May 2016. We studied associations of admission serum TMAO with in-hospital mortality (primary endpoint), 90-day mortality and neurological outcome defined by the Cerebral Performance Category (CPC) scale. Results We included 258 OHCA patients of which 44.6% died during hospitalization. Hospital non-survivors showed significantly higher admission TMAO levels (μmol L-1) compared to hospital survivors (median interquartile range (IQR) 13.2 (6.6-34.9) vs. 6.4 (2.9-15.9), p<0.001). After multivariate adjustment for other prognostic factors, TMAO levels were significantly associated with in-hospital mortality (adjusted odds ratios (OR) 2.1, 95%CI 1.1-4.2, p=0.026). Results for secondary outcomes were similar with significant associations with 90-day mortality and neurological outcome in univariate analyses. Conclusions In patients after OHCA, TMAO levels were independently associated with in-hospital mortality and other adverse clinical outcomes and may help to improve prognostication for these patients in the future. Whether TMAO levels can be influenced by nutritional interventions should be addressed in future studies.
Faculties and Departments: | 03 Faculty of Medicine 03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) 03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) 03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch) 03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch) 03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Neurologie 03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Neurologie 03 Faculty of Medicine > Departement Klinische Forschung |
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UniBasel Contributors: | Sutter, Raoul Christian |
Item Type: | Article, refereed |
Article Subtype: | Research Article |
Publisher: | De Gruyter |
ISSN: | 1434-6621 |
e-ISSN: | 1437-4331 |
Note: | Publication type according to Uni Basel Research Database: Journal article |
Identification Number: |
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Last Modified: | 22 Mar 2021 10:15 |
Deposited On: | 22 Mar 2021 10:15 |
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