Association Between Plasma Trimethyllysine and Prognosis of Patients With Ischemic Stroke

作者：Jie Xu, Mingming Zhao, Anxin Wang, Jing Xue, Si Cheng, Aichun Cheng, Jianing Gao, Qi Zhang, Rui Zhan, Xia Meng, Ming Xu, Hao Li, Lemin Zheng, Yongjun Wang · 发表于：Journal of the American Heart Association · 年份：2021 · DOI：10.1161/jaha.121.020979 · 被引用次数：19 · 研究领域：Acute Ischemic Stroke Management、Antiplatelet Therapy and Cardiovascular Diseases、Neurological Disorders and Treatments

Background Trimethyllysine, a trimethylamine N-oxide precursor, has been identified as an independent cardiovascular risk factor in acute coronary syndrome. However, limited data are available to examine the role of trimethyllysine in the population with stroke. We aimed to examine the relationship between plasma trimethyllysine levels and stroke outcomes in patients presenting with ischemic stroke or transient ischemic attack. Methods and Results Data of 10 027 patients with ischemic stroke/transient ischemic attack from the CNSR-III (Third China National Stroke Registry) and 1-year follow-up data for stroke outcomes were analyzed. Plasma levels of trimethyllysine were measured with mass spectrometry. The association between trimethyllysine and stroke outcomes was analyzed using Cox regression models. Mediation analysis was performed to examine the mediation effects of risk factors on the associations of trimethyllysine and stroke outcomes. Elevated trimethyllysine levels were associated with increased risk of cardiovascular death (quartile 4 versus quartile 1: adjusted hazard ratio [HR], 1.72; 95% CI, 1.03-2.86) and all-cause mortality (quartile 4 versus quartile 1: HR, 1.97; 95% CI, 1.40-2.78) in multivariate Cox regression model. However, no associations were found between trimethyllysine and nonfatal stroke recurrence or nonfatal myocardial infarction. Trimethyllysine was associated with cardiovascular death independent of trimethylamine N-oxide. Both estimated glomerula...