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A prospective cohort of 4071 AMI patients (mean age 60.7 years; 69.1% men) was followed for a median of 5.6 years, including 666 all-cause deaths, 365 cardiovascular deaths, and 559 incident HF events. Tryptophan metabolites were assessed by LC-MS/MS to build the TMC score and test its association and incremental risk stratification.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/prognostic-value-of-tryptophan-catabolism-base-scores-in-acute-myocardial-infarction-patients/439018/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/prognostic-value-of-tryptophan-catabolism-base-scores-in-acute-myocardial-infarction-patients/439018.png","ImageObject",300,407,{"name":92,"@type":93},"River Wang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main aim of the study in AMI patients?","Question",{"text":112,"@type":113},"To investigate the prognostic value of tryptophan catabolism-related features in patients with acute myocardial infarction (AMI).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the TMC score constructed and what was measured?",{"text":117,"@type":113},"Plasma tryptophan-related metabolites were measured by LC-MS/MS, then used to construct the TMC score based on coefficients from predictive models for MACE. Metabolite levels were also repeatedly determined after discharge in a subset of patients.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes did the TMC score relate to and how did it improve risk prediction?",{"text":121,"@type":113},"Higher TMC scores were significantly associated with all-cause death, cardiovascular death, and incident HF. The score improved risk stratification beyond established clinical risk factors (including comparison against the Grace score using multiple statistical metrics).","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},439018,1790765412,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","Journal of Advanced Research 79 (2026) 563–570  \nContents lists available at ScienceDirect  \nJournal of Advanced Research  \njournal [homepage: www. elsevier. com/locate/jare](homepage: www. elsevier. com/locate/jare)  \n| Original Manuscript |  |  |  |\n| --- | --- | --- | --- |\n| Prognostic value of tryptophan catabolism-base scores in acute myocardial infarction patients |  |  | |\n| Ye Wangb,c, 1, Pengyan Wu b,c, 1, Zhanchao Chen b,c, Zhaoying Lib,c, Yini Wang Shanjie Wang b,c,⁎, Shaohong Fangb,c,⁎, Bo Yu a,b,c,⁎\u003Cbr>a State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), China b Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, China c The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, China\u003Cbr>d Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China |  | b, Miao Yan b,c, Yiying Zhang d, |  |\n| h i g h l i g h t s\u003Cbr>• The TMC score was developed to investigate Tryptophan catabolism dysfunction in an AMI cohort.\u003Cbr>• The TMC score was significantly associated with all-cause mortality, cardiovascular mortality, and incident HF.\u003Cbr>• The TMC score improved risk stratification beyond established clinical risk factors. | g r a p h i c a l a b s t r a c t\u003Cbr>(A) Forest plot for association between Trp metabolites and incident MACE. Adjusted for Trp, Kyn, IPA and ILA. 4071 patients with AMI were admitted into the hospital, and 1044 of them went outpatient followup. (B) Forest plot for association between Trp metabolites and MACE, adjusted for Trp, Kyn, IPA and ILA.(C) Associations between TMC scores and outcomes. (D) Comparison between two TMC score regression coefficients.\u003Cbr>|  |  |\n\na r t i c l e i n f o  \nArticle history:  \nReceived 25 December 2024 Revised 9 March 2025  \nAccepted 14 March 2025  \nAvailable online 25 March 2025  \nKeywords:  \nTryptophan catabolism Acute myocardial infarction Indole-3-propionic acid Indole-3-lactic acid Prognosis  \na b s t r a c t  \nAims: Tryptophan catabolism is implicated in the progression of cardiovascular disease. We sought to investigate the prognostic value of tryptophan catabolism-related features in patients with acute myocardial infarction (AMI).  \nMethods and Results: A prospective cohort of 4071 patients (mean age: 60.7 years; 69. 1 % men) with AMI between February 2017 and June 2019 was included and followed up for a median of 5.6 years (IQR 5.1– 6.2). There were 666 all-cause deaths, 365 cardiovascular deaths, and 559 HF events. Plasma levels of tryptophan-related metabolites were measured using liquid chromatography tandem mass spectrometry (LC-MS/MS), and were repeatedly determined in 1044 patients after discharge. Tryptophan, kynurenine, indole-3-propionic acid, and indole-3-lactic acid were screened to construct tryptophan metabolites combination (TMC) score using coefficients from predictive models for MACE. Patients were divided into 3 groups by TMC tertiles. Patients with higher TMC score were older, more likely to be male and have hypertension. Compared to those with TMC tertile 1, patients in TMC tertile 3 had significant associations  \n⁎ Corresponding authors at: 246 Xuefu Road, Nangang District, 150086 Harbin, China.  \nE-mail addresses: [sairs@foxmail.com](sairs@foxmail.com) (S. Wang), [fangshaohong@hrbmu.edu.cn](fangshaohong@hrbmu.edu.cn) (S. Fang), [dryu_hmu@163.com](dryu_hmu@163.com) (B. Yu).  \n1 Contributed equally to this article.  \n[https://doi.org/10.1016/j.jare.2025.03.025](https://doi.org/10.1016/j.jare.2025.03.025)  \n2090-1232/© 2025 The Author(s). Published by Elsevier B.V. on behalf of Cairo University.  \nThis is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)).  \nY. Wang, P. Wu, Z. Chen et al. Journal of Advanced Research 79 (2026) 563–570  \nwith the risk of all-cause death (HR: 1.90; 95 %CI: 1.54–2.34), cardiovascular death (HR: 2.32; 95 %CI: 1.71–3. 15) ","cbCaicI352vzOlrs","https://ap.wps.com/l/cbCaicI352vzOlrs","pdf",713302,"English","# Highlights\n## TMC score development and key associations\n# Abstract\n## Aims\n## Methods and results\n## Conclusions\n# Introduction\n## Clinical risk stratification in AMI\n## Rationale on tryptophan catabolism pathways","[{\"question\":\"What is the main aim of the study in AMI patients?\",\"answer\":\"To investigate the prognostic value of tryptophan catabolism-related features in patients with acute myocardial infarction (AMI).\"},{\"question\":\"How was the TMC score constructed and what was measured?\",\"answer\":\"Plasma tryptophan-related metabolites were measured by LC-MS/MS, then used to construct the TMC score based on coefficients from predictive models for MACE. Metabolite levels were also repeatedly determined after discharge in a subset of patients.\"},{\"question\":\"What outcomes did the TMC score relate to and how did it improve risk prediction?\",\"answer\":\"Higher TMC scores were significantly associated with all-cause death, cardiovascular death, and incident HF. The score improved risk stratification beyond established clinical risk factors (including comparison against the Grace score using multiple statistical metrics).\"}]","Prognostic value of tryptophan catabolism-base scores in acute myocardial infarction patients | PDF",1790687167]