Dariush Mozaffarian: TMAO and Cardiovascular Risk Beyond Coronary Calcification
Dariush Mozaffarian, Cardiologist, Professor of Medicine at Tufts Medical Center, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in American Journal of Preventive Cardiology, adding:
“Our new research on TMAO, a diet-microbiome metabolite, and risk of coronary calcification in the MESA cohort.
Interestingly, we previously found significant associations of plasma TMAO with onset of clinical cardiovascular disease (CVD) events. But here it was not associated with coronary artery calcium (CAC), a measure of subclinical atherosclerosis .
This suggests TMAO operates through other risk pathways, unrelated to calcification or subclinical disease, such as through inflammation or clotting.
That’s consistent with several mechanistic studies which show that TMAO alters platelet hyperreactivity and thrombosis.
Specificity: one of the classic Bradford-Hill criteria for causality. The observation that TMAO is associated with clinical CVD events, but not subclinical atherosclerosis as measured by CAC, supports its causal role in clinical CVD, through other pathways such as thrombosis.
Thanks to Matthew Budoff, Salman Ansari, and our other collaborators, including my co-PI Stan Hazen at the Cleveland Clinic.
And grateful to The National Institutes of Health for supporting this work.”
Title: Trimethylamine N-Oxide, cardiometabolic risk, and coronary artery calcium in the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Salman Ansari, Kashif Shaikh, Sarah Aurit, Dariush Mozaffarian, Venkata Alla, Wilson Tang, Matthew J. Budoff
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