ObjectiveTo investigate the correlation of serum trimethylamine N-oxide (TMAO) level and coronary heart disease (CHD) and the degree of coronary artery stenosis.
MethodsA total of 390 patients who underwent coronary angiography (CAG) were selected, including 285 cases in the CHD group, 173 cases in the acute coronary syndrome (ACS) group and 112 cases in the chronic coronary syndrome (CCS) group.Another 105 patients with CHD excluded by CAG were included in the control group.ACS patients was divided into three subgroups: ST-segment elevation myocardial infarction (STEMI) group, non-ST-segment elevation myocardial infarction (NSTEMI) group and unstable angina pectoris (UAP) group.According to Gensini scoring criteria, CHD patients were divided into mild stenosis group, moderate stenosis group and severe stenosis group.Serum TMAO level was measured by enzyme-linked immunosorbent assay (ELISA), and the general information and serum TMAO level were compared among the groups.
ResultsThere were no significant differences in age, gender, height, weight, body mass index, triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine, urea nitrogen, blood glucose and history of diabetes mellitus among the three groups (P>0.05).Compared with the control group, the proportion of hypertension, the proportion of smoking, the levels of LP-PLA2, BNP and TMAO in the ACS group and CCS group were significantly increased (P < 0.01), and the levels of TC, IL-6 and hs-CRP in the ACS group were significantly higher than those in the control group (P < 0.05 to P < 0.01).Compared with the CCS group, the levels of TC, IL-6, hs-CRP, LP-PLA2 and TMAO in the ACS group were significantly higher (P < 0.01).There was no significant difference in serum TMAO level among the three groups (P>0.05).Logistic regression analysis showed that TMAO, TC, LP-PLA2, smoking and hypertension were independent risk factors for CHD (P < 0.05 to P < 0.01).ROC curve analysis showed that the optimal cut-off value of serum TMAO for diagnosing CHD was 13.80 μmol/L, AUC was 0.702, sensitivity and specificity were 73.70% and 62.90%, respectively.The AUC of TMAO+IL-6+ LP-PLA2 +hs-CRP was 0.792, and the sensitivity and specificity were 71.60% and 74.30%, respectively.The levels of TMAO in the moderate and severe stenosis groups were significantly higher than those in the mild group, and those in the severe group were significantly higher than those in the moderate group (P < 0.01).
ConclusionsThe level of serum TMAO in patients with CHD is higher, and the level in patients with ACS is higher than that in patients with CCS, which is an independent risk factor for CHD and can be used as a potential index for the diagnosis and evaluation of the degree of coronary artery stenosis in CHD.
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