Analysis Of The Relationship Between Serum Trimethylamine Oxide And Coronary Heart Disease And The Degree Of Coronary Artery Stenosis

Objective:To investigate the relationship between serum trimethylamine oxide（TMAO）water and coronary heart disease（CHD）and the degree of coronary artery stenosis.Methods:A total of 390 patients who underwent coronary angiography（CAG）in the department of cardiology of our hospital from June 2020 to March 2021 were selected,including 285 patients in CHD group,including 173 patients with acute coronary syndrome（ACS）and 112 patients with chronic coronary syndrome（CCS）,and105patients with coronary heart disease excluded by CAG as control group（105patients excluded by CAG）.The level of serum TMAO was measured by enzyme-linked immunosorbent assay（ELISA）,and the general data and serum TMAO levels of each group were compared.Results:There was no significant difference in age,sex,height,weight,body mass index（BMI）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,creatinine,blood urea nitrogen,blood glucose and history of diabetes among ACS,CCS and control groups.Compared with the control group,the proportion of hypertension,the levels of lipoprotein phospholipase A2（Lp-PLA2）,brain natriuretic peptide（BNP）,troponin I（c TNI）and TMAO in the ACS group and CCS group were significantly higher than those in the control group.The proportion of smoking,the levels of total cholesterol（TC）,interleukin-6（IL-6）and hypersensitive C-reactive protein（hs-CRP）in the ACS group were significantly higher than those in the control group.Compared with CCS group,the levels of TC,c TNI,IL-6,hs-CRP and TMAO in ACS group were significantly higher than those in CCS group.There was no significant difference in serum TMAO levels among ST segment elevation myocardial infarction（STEMI）group,non-ST segment elevation myocardial infarction（NSTEMI）group and unstable angina pectoris（UA）group in ACS subgroup.Multivariate Logistic regression analysis showed that TMAO,TC,Lp-PLA2,smoking and hypertension were independent risk factors for CHD（OR>1,P<0.05）.The results of ROC curve analysis showed that when the best critical value of serum TMAO for CHD diagnosis was 13.795μmol/L,AUC was 0.702,sensitivity and specificity were73.70%and 62.90%,respectively,and Yoden’s index was 0.366.The AUC of TMAO+IL-6+Lp-PLA2+hs-CRP was 0.792,the sensitivity and specificity were 71.60%and 74.30%,respectively,and the Yoden index was 0.459.There were significant differences in the distribution of TMAO levels among different coronary stenosis groups.The serum TMAO levels in mild stenosis group,moderate stenosis group and severe stenosis group were（15.08±3.20）μmol/L,（18.19±4.18）μmol/L and（21.97±3.98）μmol/L,TMAO,respectively,and there were significant differences between the two groups（P<0.001）.Spearman correlation analysis showed that the level of serum TMAO was positively correlated with the level of IL-6 in patients with ACS（r_s=0.569,P<0.001）.Conclusion:The level of serum TMAO in patients with CHD is higher,and the level in patients with ACS is higher than that in patients with CCS,which is an independent risk factor for CHD and can be used as a potential index for the diagnosis and evaluation of coronary artery stenosis in CHD.