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Updated: Aug 9, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Trimethylamine N-Oxide and Stroke Recurrence Depends on Ischemic Stroke Subtypes
Jie Xu1,2,3, Aichun Cheng1,2,3, Bo Song4
1Department of Neurology, Beijing Tiantan Hospital (J. Xu, A.C., J. Xue, A.W., L.D., J.J., X.M., H.L., L.Z., Y.W.), Capital Medical University, China.
Stroke
|November 19, 2021
Summary
Trimethylamine N-oxide (TMAO) is linked to higher stroke recurrence risk, particularly in small artery occlusion subtypes. This finding highlights TMAO as a potential biomarker for predicting recurrent ischemic events.
Area of Science:
- Neurology
- Cardiovascular Research
- Biomarkers
Background:
- Trimethylamine N-oxide (TMAO) is a known cardiovascular disease risk factor.
- The specific role of TMAO in ischemic stroke, a heterogeneous condition, requires further elucidation.
- Understanding TMAO's impact across different stroke etiologies is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between plasma TMAO levels and the risk of stroke recurrence.
- To analyze this association across various ischemic stroke etiological subtypes classified by TOAST criteria.
- To conduct a meta-analysis to confirm the relationship between TMAO and stroke risk.
Main Methods:
- Analysis of 1-year follow-up data for stroke recurrence in 10,756 patients from the Third China National Stroke Registry.
- Classification of stroke etiology using TOAST criteria.
- Quantification of plasma TMAO via liquid chromatography-mass spectrometry and analysis using Cox regression models and meta-analysis.
Main Results:
- Elevated TMAO levels were independently associated with an increased risk of stroke recurrence (aHR, 1.37).
- A significant association was observed between TMAO and recurrence in the small artery occlusion subtype (aHR, 1.43).
- The association was attenuated in large-artery atherosclerosis, cardioembolism, and other subtypes.
Conclusions:
- Elevated TMAO levels are associated with a higher risk of stroke recurrence, especially in patients with the small artery occlusion subtype.
- TMAO may serve as a valuable biomarker for predicting recurrent ischemic stroke in specific etiological groups.
- Further research is warranted to explore the mechanisms underlying TMAO's role in different stroke subtypes.
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