Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection

Judith M Haissman; Andreas Knudsen; Hedda Hoel; Andreas Kjær; Ulrik S Kristoffersen; Rolf K Berge; Terese L Katzenstein; Asbjørn Svardal; Thor Ueland; Pål Aukrust; Anne-Mette Lebech; Susanne D Nielsen; Marius Trøseid

doi:10.1097/QAI.0000000000000843

Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection

Judith M Haissman, Andreas Knudsen, Hedda Hoel, Andreas Kjær, Ulrik S Kristoffersen, Rolf K Berge, Terese L Katzenstein, Asbjørn Svardal, Thor Ueland, Pål Aukrust, Anne-Mette Lebech, Susanne D Nielsen, Marius Trøseid

30 Citations (Scopus)

Abstract

OBJECTIVES: HIV infection is associated with increased risk of coronary heart disease beyond that explained by traditional risk factors, and altered gut microbiota has been proposed as a potential trigger. Trimethylamine-N-oxide (TMAO) is a proatherogenic substance formed in the liver from trimethylamine, exclusively generated by gut microbiota from dietary phosphatidylcholine. We aimed to investigate whether TMAO is associated with subclinical and clinical coronary heart disease in HIV infection.

METHODS: Two previously described cohorts were examined as follows: (1) cross-sectional cohort of HIV-infected persons and uninfected controls with known atherosclerotic plaque burden as assessed by myocardial perfusion scintigraphy, coronary artery calcium score, and intima-media thickness and (2) nested case-control study of HIV-infected persons with first-time myocardial infarction (MI) compared with HIV-infected persons without MI, assessed at 4 time points from before initiation of antiretroviral therapy (ART) to last sample before the case's MI (median: 51, range: 0-239 days).

RESULTS: There was no difference in plasma TMAO when comparing HIV-infected persons and uninfected controls. TMAO was elevated in HIV-infected persons with myocardial perfusion defects but was not associated with coronary artery calcium score, intima media thickness, or Framingham risk score. In the nested case control study, plasma TMAO was not associated with first-time MI. However, TMAO increased after ART introduction and was associated with the use of protease inhibitors in both cohorts.

CONCLUSIONS: TMAO was elevated in HIV-infected persons with myocardial perfusion defects, but was not associated with first-time MI. Our data question TMAO as a useful biomarker of cardiovascular risk in HIV infection, at least in ART-treated individuals.

Original language	English
Journal	Journal of Acquired Immune Deficiency Syndromes
Volume	71
Issue number	2
Pages (from-to)	130-136
Number of pages	7
ISSN	1525-4135
DOIs	https://doi.org/10.1097/QAI.0000000000000843
Publication status	Published - 1 Feb 2016

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10.1097/QAI.0000000000000843

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Haissman, J. M., Knudsen, A., Hoel, H., Kjær, A., Kristoffersen, U. S., Berge, R. K., Katzenstein, T. L., Svardal, A., Ueland, T., Aukrust, P., Lebech, A-M., Nielsen, S. D., & Trøseid, M. (2016). Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection. Journal of Acquired Immune Deficiency Syndromes, 71(2), 130-136. https://doi.org/10.1097/QAI.0000000000000843

Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection. / Haissman, Judith M; Knudsen, Andreas; Hoel, Hedda et al.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 71, No. 2, 01.02.2016, p. 130-136.

Research output: Contribution to journal › Journal article › Research › peer-review

Haissman, JM, Knudsen, A, Hoel, H, Kjær, A, Kristoffersen, US, Berge, RK, Katzenstein, TL, Svardal, A, Ueland, T, Aukrust, P, Lebech, A-M, Nielsen, SD & Trøseid, M 2016, 'Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection', Journal of Acquired Immune Deficiency Syndromes, vol. 71, no. 2, pp. 130-136. https://doi.org/10.1097/QAI.0000000000000843

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title = "Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection",

abstract = "OBJECTIVES: HIV infection is associated with increased risk of coronary heart disease beyond that explained by traditional risk factors, and altered gut microbiota has been proposed as a potential trigger. Trimethylamine-N-oxide (TMAO) is a proatherogenic substance formed in the liver from trimethylamine, exclusively generated by gut microbiota from dietary phosphatidylcholine. We aimed to investigate whether TMAO is associated with subclinical and clinical coronary heart disease in HIV infection.METHODS: Two previously described cohorts were examined as follows: (1) cross-sectional cohort of HIV-infected persons and uninfected controls with known atherosclerotic plaque burden as assessed by myocardial perfusion scintigraphy, coronary artery calcium score, and intima-media thickness and (2) nested case-control study of HIV-infected persons with first-time myocardial infarction (MI) compared with HIV-infected persons without MI, assessed at 4 time points from before initiation of antiretroviral therapy (ART) to last sample before the case's MI (median: 51, range: 0-239 days).RESULTS: There was no difference in plasma TMAO when comparing HIV-infected persons and uninfected controls. TMAO was elevated in HIV-infected persons with myocardial perfusion defects but was not associated with coronary artery calcium score, intima media thickness, or Framingham risk score. In the nested case control study, plasma TMAO was not associated with first-time MI. However, TMAO increased after ART introduction and was associated with the use of protease inhibitors in both cohorts.CONCLUSIONS: TMAO was elevated in HIV-infected persons with myocardial perfusion defects, but was not associated with first-time MI. Our data question TMAO as a useful biomarker of cardiovascular risk in HIV infection, at least in ART-treated individuals.",

author = "Haissman, {Judith M} and Andreas Knudsen and Hedda Hoel and Andreas Kj{\ae}r and Kristoffersen, {Ulrik S} and Berge, {Rolf K} and Katzenstein, {Terese L} and Asbj{\o}rn Svardal and Thor Ueland and P{\aa}l Aukrust and Anne-Mette Lebech and Nielsen, {Susanne D} and Marius Tr{\o}seid",

year = "2016",

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doi = "10.1097/QAI.0000000000000843",

language = "English",

volume = "71",

pages = "130--136",

journal = "J A I D S",

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publisher = "Lippincott Williams & Wilkins",

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T1 - Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection

AU - Haissman, Judith M

AU - Knudsen, Andreas

AU - Hoel, Hedda

AU - Kjær, Andreas

AU - Kristoffersen, Ulrik S

AU - Berge, Rolf K

AU - Katzenstein, Terese L

AU - Svardal, Asbjørn

AU - Ueland, Thor

AU - Aukrust, Pål

AU - Lebech, Anne-Mette

AU - Nielsen, Susanne D

AU - Trøseid, Marius

PY - 2016/2/1

Y1 - 2016/2/1

N2 - OBJECTIVES: HIV infection is associated with increased risk of coronary heart disease beyond that explained by traditional risk factors, and altered gut microbiota has been proposed as a potential trigger. Trimethylamine-N-oxide (TMAO) is a proatherogenic substance formed in the liver from trimethylamine, exclusively generated by gut microbiota from dietary phosphatidylcholine. We aimed to investigate whether TMAO is associated with subclinical and clinical coronary heart disease in HIV infection.METHODS: Two previously described cohorts were examined as follows: (1) cross-sectional cohort of HIV-infected persons and uninfected controls with known atherosclerotic plaque burden as assessed by myocardial perfusion scintigraphy, coronary artery calcium score, and intima-media thickness and (2) nested case-control study of HIV-infected persons with first-time myocardial infarction (MI) compared with HIV-infected persons without MI, assessed at 4 time points from before initiation of antiretroviral therapy (ART) to last sample before the case's MI (median: 51, range: 0-239 days).RESULTS: There was no difference in plasma TMAO when comparing HIV-infected persons and uninfected controls. TMAO was elevated in HIV-infected persons with myocardial perfusion defects but was not associated with coronary artery calcium score, intima media thickness, or Framingham risk score. In the nested case control study, plasma TMAO was not associated with first-time MI. However, TMAO increased after ART introduction and was associated with the use of protease inhibitors in both cohorts.CONCLUSIONS: TMAO was elevated in HIV-infected persons with myocardial perfusion defects, but was not associated with first-time MI. Our data question TMAO as a useful biomarker of cardiovascular risk in HIV infection, at least in ART-treated individuals.

AB - OBJECTIVES: HIV infection is associated with increased risk of coronary heart disease beyond that explained by traditional risk factors, and altered gut microbiota has been proposed as a potential trigger. Trimethylamine-N-oxide (TMAO) is a proatherogenic substance formed in the liver from trimethylamine, exclusively generated by gut microbiota from dietary phosphatidylcholine. We aimed to investigate whether TMAO is associated with subclinical and clinical coronary heart disease in HIV infection.METHODS: Two previously described cohorts were examined as follows: (1) cross-sectional cohort of HIV-infected persons and uninfected controls with known atherosclerotic plaque burden as assessed by myocardial perfusion scintigraphy, coronary artery calcium score, and intima-media thickness and (2) nested case-control study of HIV-infected persons with first-time myocardial infarction (MI) compared with HIV-infected persons without MI, assessed at 4 time points from before initiation of antiretroviral therapy (ART) to last sample before the case's MI (median: 51, range: 0-239 days).RESULTS: There was no difference in plasma TMAO when comparing HIV-infected persons and uninfected controls. TMAO was elevated in HIV-infected persons with myocardial perfusion defects but was not associated with coronary artery calcium score, intima media thickness, or Framingham risk score. In the nested case control study, plasma TMAO was not associated with first-time MI. However, TMAO increased after ART introduction and was associated with the use of protease inhibitors in both cohorts.CONCLUSIONS: TMAO was elevated in HIV-infected persons with myocardial perfusion defects, but was not associated with first-time MI. Our data question TMAO as a useful biomarker of cardiovascular risk in HIV infection, at least in ART-treated individuals.

U2 - 10.1097/QAI.0000000000000843

DO - 10.1097/QAI.0000000000000843

M3 - Journal article

C2 - 26413854

SN - 1525-4135

VL - 71

SP - 130

EP - 136

JO - J A I D S

JF - J A I D S

IS - 2

ER -

Microbiota-Dependent Marker TMAO Is Elevated in Silent Ischemia but Is Not Associated With First-Time Myocardial Infarction in HIV Infection

Abstract

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