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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Age Factors, Aged, Aged, 80 and over, Anti-Bacterial Agents, Cause of Death, Cerebrovascular Disorders, Chromatography, Liquid, Community-Acquired Infections, Coronary Artery Disease, Female, Fever, Heart Failure, Hospitalization, Humans, Length of Stay, Longitudinal Studies, Male, Methylamines, Middle Aged, Mortality, Neoplasms, Pneumonia, Prognosis, Proportional Hazards Models, Prospective Studies, Renal Insufficiency, Chronic, Risk Factors, Switzerland, Tandem Mass Spectrometry.
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Does trimethylamine-N-oxide ( TMAO ) predict fatal outcomes in community-acquired pneumonia patients without evident coronary artery disease? Context: The pro-atherosclerotic metabolite trimethylamine-N-oxide (TMAO) is a risk factor for incident cardiovascular events and a potentially modifiable mediator of chronic inflammation through broad-spectrum antibiotic treatment by changing the microbiome. Whether TMAO is associated with adverse clinical outcomes in acute inflammatory community-acquired pneumonia (CAP) patients is unknown. A total of 317 CAP patients from a previous Swiss multicenter trial were prospectively followed for a median of 6.1years. TMAO plasma levels were measured by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). We used Cox regression models to investigate associations between baseline TMAO levels and all-cause mortality. Six-year mortality was 45.1%, and 18.9% of the patients had coronary artery disease (CAD). Median admission TMAO (μmolL
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TMAO is associated with long-term fatal outcomes in CAP patients without evident CAD and modifiable through antibiotic treatment. Whether chronic modulation of TMAO by targeting the microbiome reduces mortality risk needs to be evaluated in future interventional trials. Final Decision: yes