Tryptophan metabolites and stroke risk after acute myocardial infarction in patients with and without metabolic syndrome: insights from a major adverse cardiac and cerebrovascular events (MACCE)-based cohort
Authors' conclusion
Tryptophan metabolic dysregulation, particularly elevated KYN, was associated with a higher risk of stroke in AMI-MetS patients.
Study context
- Population
- Acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention, enrolled 2017–20213,190 in validation
- Participants
- 3,223 patients
- Exposure
- Tryptophan metabolite levels in metabolic syndrome (MetS) vs non-MetS patients
- Outcome
- Stroke risk
Methodological detailsuntargeted metabolomics with internal validation, Cox regression stratified by MetS, random forest prediction model
- Untargeted metabolomics with internal validation
- Cox regression stratified by MetS
- Random forest prediction model
Main finding
As reported in the abstract
Stroke risk per twofold increase in metabolite level
| Group | Adjusted HR, ILA | Adjusted HR, tryptophan (TRP) | Adjusted HR, kynurenine (KYN) |
|---|---|---|---|
| MetS | 1.34 | 1.46 | 1.47 |
MetS
Adjusted HR, ILA1.34
Adjusted HR, tryptophan (TRP)1.46
Adjusted HR, kynurenine (KYN)1.47
Observational data: associations, not effects.
Further findings
Random forest model predicting MACCE · 72-month follow-up
- AUC
- 0.715 (95% CI 0.683-0.747)
- KYN and ILA identified as major predictive features
Original publication
Tryptophan metabolites and stroke risk after acute myocardial infarction in patients with and without metabolic syndrome: insights from a MACCE-based cohort. Cardiovasc Diabetol. Published 19 March 2026. doi:10.
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