Utility of trimethylamine oxide (TMAO) in predicting early neurological deterioration after acute ischemic stroke | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2023]

Author(s):

1. Yi Kang: Department of Encephalopathy, Jiulongpo District Hospital of Traditional Chinese Medicine,Chongqing City,China

2. Hui Cheng: Department of Encephalopathy, Jiulongpo District Hospital of Traditional Chinese Medicine,Chongqing City,China

3. Yanfang Shi: Department of Encephalopathy, Jiulongpo District Hospital of Traditional Chinese Medicine,Chongqing City,China

4. Junbing Liu: Department of Encephalopathy, Jiulongpo District Hospital of Traditional Chinese Medicine,Chongqing City,China

5. Yue Wang: Department of Encephalopathy, Jiulongpo District Hospital of Traditional Chinese Medicine,Chongqing City,China

6. Dong Wan: Department of Critical Medicine, The First Clinical College Affiliated to Chongqing Medical University,Chongqing,China

Abstract:

Objective: To investigate whether plasma trimethylamine N-oxide (TMAO) levels might predict early neurological deterioration (END) in individuals with acute ischemic stroke. Study Design: Cohort study. Place and Duration of the Study: Jiulongpo District Hospital of Traditional Chinese Medicine, Chongqing City, China, from January 2020 to December 2021. Methodology: Patients presenting with ischemic stroke were classi ed intothe END group and the non-END group. The National Institutes of Health Stroke Scale (NIHSS) total increasing by 2 points or more within 72 hours of admission was the de nition of the END. Plasma TMAO levels were determined by high-performance liquid chromatographic and tandem mass spectrometry. Results: Twenty-six (25%) of the 104 patients, diagnosed with END exhibited higher TMAO levels after admission (median 1.438 vs. 0.449 nmol/mL, p=0.001). Elevated plasma TMAO levels were signi cant predictors of END in univariate logistic analysis. After controlling for age, gender, and cardiovascular risk factors in the multivariate conditional logistic regression model, the plasma TMAO levels in the END group remained signi cantly higher than those in the non-END group (OR=6.646, 95% CI 2.434-18.147, p<0.001). In receiver operator characteristic (ROC) analysis, the sensitivity and speci city of TMAO in distinguishing the END group and the non-END group at 0.564 nmol/mL cuto value were 0.885 and 0.679, respectively. Conclusion: According to this research, the development of END on admission in patients with acute ischemic stroke may be positively correlated with the elevation in plasma TMAO levels.

Page(s): 861-865

DOI: 10.29271/jcpsp.2023.08.861

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 33, Issue: 8, Year: 2023

Keywords:

acute ischemic stroke , Trimethylamine Noxide level , Early neurological deterioration , NIHSS score

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