P6509Plasma trimethylamine n-oxide level is associated with neoatherosclerosis in patients with very late stent thrombosis

Abstract

Abstract Background Trimethylamine N-oxide (TMAO) has been demonstrated to promote the pathogenesis of atherosclerosis. It is unknown whether plasma TMAO is associated with neoatherosclerosis, an important underlying mechanism of very late stent thrombosis (VLST). We investigated the relationship between the culprit plaque morphology and plasma TMAO concentration in patients with ST-segment elevation myocardial infarction caused by VLST. Methods Optical coherence tomography (OCT) was used to evaluate the culprit lesion morphology. Thirty consecutive patients with VLST were enrolled; 17 patients were identified as neoatherosclerosis and 13 without neoatherosclerosis. Patients with neoatheroslcerosis were further divided into two subgroups, including 11 patients with plaque rupture and 6 without plaque rupture, respectively. Results The plasma TMAO levels were significantly higher in patients with VLST than in healthy individuals (3.64 μM [2.08–4.58] vs. 1.47 μM [0.89–2.75], p<0.001). Within VLST patients, plasma TMAO levels were significantly higher in patients with neoatherosclerosis than in those without neoathersclerosis (4.35 μM [3.43–5.37] vs. 2.02 μM [1.30–3.59]; p<0.001). The logistic analysis revealed that plasma TMAO was a predictor of neoatherosclerosis (odds ratio: 3.35, 95% confidence interval: 1.40–8.03; p=0.007). In addition, patients with neoatherosclerosis with plaque rupture had significantly elevated plasma TMAO concentration than those without plaque rupture (5.29 μM [4.35–7.21] vs. 3.63 μM [3.02–3.92]; p=0.012). The area under receiver operating characteristic curve for patients with neoatherosclerosis versus those without neoatherosclerosis was 0.87, the corresponding sensitivity and specificity was 0.77 and 0.88, respectively. The comparison of plasma TMAO level Conclusions High plasma TMAO was associated with neoatherosclerosis and plaque rupture in patients with VLST. Acknowledgement/Funding This study was supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2016-I2M-1-009)