Patient demographics at time of admission to hospital with AHF
| Combined | TMAO <5.6 µM | TMAO >5.6 µM | p Value | |
|---|---|---|---|---|
| Ages (years) | 78 (69–84) | 76 (66–82) | 79 (72–85) | <0.0005 |
| Male | 61% | 62% | 61% | NS |
| Systolic BP (mm Hg) | 133 (115–150) | 135 (118–153) | 130 (113–148) | 0.005 |
| Diastolic BP (mm Hg) | 75 (65–85) | 77 (68–87) | 71 (62–81) | <0.0005 |
| Heart rate (bpm) | 88 (74–105) | 90 (75–110) | 85 (72–103) | 0.02 |
| De novo HF (%) | 66.4 | 72.6 | 60.3 | <0.0005 |
| Past history IHD (%) | 29.1 | 28.4 | 29.8 | NS |
| Past history diabetes (%) | 33.8 | 29.5 | 38.1 | 0.005 |
| Past history hypertension (%) | 58.3 | 55.7 | 60.9 | 0.098 |
| Past history COPD (%) | 9.2 | 8.2 | 10.1 | NS |
| Past history hyperlipidaemia (%) | 24.4 | 25.4 | 23.5 | NS |
| Smoker (%) | 9.6 | 11.3 | 7.8 | 0.062 |
| Orthopnoea (%) | 53.1 | 51.3 | 54.9 | NS |
| Oedema (%) | 62.4 | 57.1 | 67.7 | 0.001 |
| Raised JVP (%) | 54.6 | 54.8 | 54.3 | NS |
| Pulmonary oedema (%) | 31.7 | 33.5 | 30.0 | NS |
| NYHA class IV (%) | 54.9 | 51.6 | 58.1 | 0.042 |
| Atrial fibrillation (%) | 45.4 | 41.4 | 49.4 | 0.012 |
| HFREF (%)* | 58.5 | 54.8 | 62.3 | 0.038 |
| Idiopathic dilated CM (%) | 5.3 | 5.4 | 5.2 | NS |
| Ischaemic heart disease (%) | 40.4 | 37.4 | 43.3 | 0.077 |
| Hypertension (%) | 25.0 | 23.9 | 26.2 | NS |
| Valvular heart disease (%) | 7.5 | 6.9 | 8.2 | NS |
| Alcoholic CM (%) | 0.7 | 1.2 | 0.2 | 0.059 |
| Other aetiology (%) | 22.2 | 26.6 | 17.9 | 0.001 |
| Respiratory rate (breaths/min) | 22 (18–25) | 22 (18–26) | 21 (19–24) | NS |
| Urea (mmol/L) | 8.9 (6.5–12.9) | 7.3 (5.7–9.3) | 11.4 (8.4–16.3) | <0.0005 |
| Creatinine (µmol/L) | 113 (91–142) | 99 (83–117) | 133 (108–176) | <0.0005 |
| eGFR (mL/min/1.73 m2) | 51 (39–67) | 61 (49–75) | 42 (33–54) | <0.0005 |
| Na+ (mmol/L) | 138 (135–141) | 138 (134–141) | 139 (135–141) | 0.069 |
| K+ (mmol/L) | 4.4 (4.0–4.7) | 4.3 (4.0–4.6) | 4.5 (4.1–4.8) | <0.0005 |
| Haemoglobin (g/L) | 123 (109–137) | 126 (112–139) | 121 (106–135) | <0.0005 |
| NT-proBNP (pmol/L) | 2124 (969–3836) | 1876 (845–2948) | 2449 (1194–4612) | <0.0005 |
| TMAO (µmol/L) | 5.6 (3.4–10.5) | 3.4 (2.5–4.4) | 10.5 (7.3–17.5) | <0.0005 |
| ADHERE18 group 3–5 (%) | 16.4 | 3.8 | 29.2 | <0.0005 |
| OPTIMZE-HF19 score | 34 (29–39) | 33 (28–37) | 36 (31–41) | <0.0005 |
| GWTG-HF20 score | 43 (37–48) | 41 (36–46) | 45 (39–50) | <0.0005 |
| Endpoints | ||||
| In-hospital death | 72 | 18 | 54 | <0.0005 |
| Death at 1 year | 268 | 102 | 166 | <0.0005 |
| Death/HF at 1 year | 384 | 152 | 232 | <0.0005 |
Data expressed as median (IQR) for continuous variables and % of total for categorical variables.
*Echocardiogram data available for 737 patients only.
AHF, acute heart failure; BP, blood pressure; CM, cardiomyopathy; COPD, chronic obstructive pulmonary disease; eGFR, estimated glomerular filtration rate; HF, heart failure; HFREF, heart failure with reduced ejection fracture; IHD, ischaemic heart disease; JVP, jugular venous pressure; NT-proBNP, N-terminal pro B-type natriuretic peptide; NYHA, New York Heart Association; TMAO, trimethylamine N-oxide.