SynthesisFrontiers in cardiovascular medicine2026
Plasma trimethylamine N-oxide and arteriosclerotic cardiovascular disease: a systematic review and meta-analysis of case-control studies.
Synthesis in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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9 authors.
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Abstract
Introduction: Trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite, has been implicated in atherosclerosis. However, the association between plasma TMAO levels and atherosclerotic cardiovascular disease (ASCVD) risk remains inconsistent across studies. Methods: We searched PubMed, Embase, Cochrane, and Web of Science for case-control (including nested) studies reporting odds ratios (ORs) with 95% confidence intervals (CIs) for TMAO and ASCVD. Estimates were pooled under fixed- or random-effects assumptions according to the observed heterogeneity, supplemented by subgroup, sensitivity, and publication bias assessments. Results: Nine studies were included in this meta-analysis. Elevated TMAO levels (highest vs. lowest quantile) were significantly associated with ASCVD risk (OR = 1.39; 95% CI: 1.21-1.61; Discussion: This meta-analysis showed that high versus low plasma TMAO levels were significantly associated with increased ASCVD risk (OR = 1.39; 95% CI: 1.21-1.61), particularly in primary prevention populations (OR = 1.51; 95% CI: 1.28-1.78), and supported TMAO as a potential risk indicator for primary prevention. However, continuous analysis yielded highly unstable estimates with extreme heterogeneity ( Systematic Review Registration: PROSPERO CRD420261357905.
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