Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection
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Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection. / Haissman, Judith M; Knudsen, Andreas; Hoel, Hedda; Kjær, Andreas; Kristoffersen, Ulrik S; Berge, Rolf K; Katzenstein, Terese L; Svardal, Asbjørn; Ueland, Thor; Aukrust, Pål; Lebech, Anne-Mette; Nielsen, Susanne D; Trøseid, Marius.
In: Journal of Acquired Immune Deficiency Syndromes, Vol. 71, No. 2, 01.02.2016, p. 130-136.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection
AU - Haissman, Judith M
AU - Knudsen, Andreas
AU - Hoel, Hedda
AU - Kjær, Andreas
AU - Kristoffersen, Ulrik S
AU - Berge, Rolf K
AU - Katzenstein, Terese L
AU - Svardal, Asbjørn
AU - Ueland, Thor
AU - Aukrust, Pål
AU - Lebech, Anne-Mette
AU - Nielsen, Susanne D
AU - Trøseid, Marius
PY - 2016/2/1
Y1 - 2016/2/1
N2 - OBJECTIVES: HIV infection is associated with increased risk of coronary heart disease beyond that explained by traditional risk factors, and altered gut microbiota has been proposed as a potential trigger. Trimethylamine-N-oxide (TMAO) is a proatherogenic substance formed in the liver from trimethylamine, exclusively generated by gut microbiota from dietary phosphatidylcholine. We aimed to investigate whether TMAO is associated with subclinical and clinical coronary heart disease in HIV infection.METHODS: Two previously described cohorts were examined as follows: (1) cross-sectional cohort of HIV-infected persons and uninfected controls with known atherosclerotic plaque burden as assessed by myocardial perfusion scintigraphy, coronary artery calcium score, and intima-media thickness and (2) nested case-control study of HIV-infected persons with first-time myocardial infarction (MI) compared with HIV-infected persons without MI, assessed at 4 time points from before initiation of antiretroviral therapy (ART) to last sample before the case's MI (median: 51, range: 0-239 days).RESULTS: There was no difference in plasma TMAO when comparing HIV-infected persons and uninfected controls. TMAO was elevated in HIV-infected persons with myocardial perfusion defects but was not associated with coronary artery calcium score, intima media thickness, or Framingham risk score. In the nested case control study, plasma TMAO was not associated with first-time MI. However, TMAO increased after ART introduction and was associated with the use of protease inhibitors in both cohorts.CONCLUSIONS: TMAO was elevated in HIV-infected persons with myocardial perfusion defects, but was not associated with first-time MI. Our data question TMAO as a useful biomarker of cardiovascular risk in HIV infection, at least in ART-treated individuals.
AB - OBJECTIVES: HIV infection is associated with increased risk of coronary heart disease beyond that explained by traditional risk factors, and altered gut microbiota has been proposed as a potential trigger. Trimethylamine-N-oxide (TMAO) is a proatherogenic substance formed in the liver from trimethylamine, exclusively generated by gut microbiota from dietary phosphatidylcholine. We aimed to investigate whether TMAO is associated with subclinical and clinical coronary heart disease in HIV infection.METHODS: Two previously described cohorts were examined as follows: (1) cross-sectional cohort of HIV-infected persons and uninfected controls with known atherosclerotic plaque burden as assessed by myocardial perfusion scintigraphy, coronary artery calcium score, and intima-media thickness and (2) nested case-control study of HIV-infected persons with first-time myocardial infarction (MI) compared with HIV-infected persons without MI, assessed at 4 time points from before initiation of antiretroviral therapy (ART) to last sample before the case's MI (median: 51, range: 0-239 days).RESULTS: There was no difference in plasma TMAO when comparing HIV-infected persons and uninfected controls. TMAO was elevated in HIV-infected persons with myocardial perfusion defects but was not associated with coronary artery calcium score, intima media thickness, or Framingham risk score. In the nested case control study, plasma TMAO was not associated with first-time MI. However, TMAO increased after ART introduction and was associated with the use of protease inhibitors in both cohorts.CONCLUSIONS: TMAO was elevated in HIV-infected persons with myocardial perfusion defects, but was not associated with first-time MI. Our data question TMAO as a useful biomarker of cardiovascular risk in HIV infection, at least in ART-treated individuals.
U2 - 10.1097/QAI.0000000000000843
DO - 10.1097/QAI.0000000000000843
M3 - Journal article
C2 - 26413854
VL - 71
SP - 130
EP - 136
JO - J A I D S
JF - J A I D S
SN - 1525-4135
IS - 2
ER -
ID: 161271184