Table 2.
Risk of a Major Adverse Cardiovascular Event at 3 Years, According to Quartile of TMAO Level.*
| Risk of Event | TMAO Level | ||||||
|---|---|---|---|---|---|---|---|
| Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | ||||
| reference | hazard ratio (95% CI) |
P value | hazard ratio (95% CI) |
P value | hazard ratio (95% CI) |
P value | |
| Unadjusted hazard ratio | 1.00 | 1.24 (0.93–1.66) | 0.15 | 1.53 (1.16–2.02) | 0.003 | 2.54 (1.96–3.28) | <0.001 |
| Adjusted hazard ratio | |||||||
| Model 1† | 1.00 | 1.14 (0.86–1.53) | 0.37 | 1.29 (0.98–1.71) | 0.07 | 1.88 (1.44–2.44) | <0.001 |
| Model 2‡ | 1.00 | 1.08 (0.79–1.48) | 0.61 | 1.15 (0.85–1.56) | 0.36 | 1.49 (1.10–2.03) | 0.01 |
| Model 3§ | 1.00 | 1.06 (0.77–1.45) | 0.72 | 1.11 (0.82–1.51) | 0.50 | 1.43 (1.05–1.94) | 0.02 |
A major adverse cardiovascular event was defined as death, myocardial infarction, or stroke. The quartiles of TMAO levels are as follows: quartile 1, less than 2.43 µM; quartile 2 2.43 to 3.66 µM; quartile 3, 3.67 to 6.18 µM; and quartile 4, more than 6.18 µM. Hazard ratios and P values are for the comparison with quartile 1.
In model 1, hazard ratios were adjusted for traditional risk factors (age, sex, smoking status, systolic blood pressure, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, and status with respect to diabetes mellitus), plus log-transformed high-sensitivity C-reactive protein level.
In model 2, hazard ratios were adjusted for all factors in model 1, plus myeloperoxidase level, log-transformed estimated glomerular filtration rate, total white-cell count, body-mass index, and status with respect to receipt of certain medications (aspirin, statin, ACE inhibitor, ARB, or beta-blocker).
In model 3, hazard ratios were adjusted for all factors in model 2, plus the extent of disease, as seen on angiography.