Key result
Elevated serum TMAO levels and specific gut microbial taxa were significantly associated with acute coronary syndrome, although the association with 1-year post-STEMI cardiovascular events was not statistically significant.
Why the study?
Associations between gut microbes in acute coronary syndrome and post-STEMI events were unknown.
Are specific gut microbial taxa and systemic TMAO levels associated with acute coronary syndrome and incident post-STEMI cardiovascular events?
Observational (n=90)
No
Are specific gut microbial taxa and systemic TMAO levels associated with acute coronary syndrome and incident post-STEMI cardiovascular events?
Absolute Event Rate: 4.33% vs 2.15%
p-value: p=<0.001
Specific gut microbial taxa and their metabolite TMAO are significantly altered in patients with acute coronary syndrome and may serve as potential predictive biomarkers.
Supports TMAO and microbiota as potential ACS biomarkers; leaves open prognostic value for post-STEMI events.
Plasma trimethylamine N-oxide (TMAO) is associated with coronary atherosclerotic plaque and cardiovascular disease risk, but associations between gut microbes in acute coronary syndrome (ACS) and post-ST-segment elevation myocardial infarction (post-STEMI) events are unknown. We investigated associations between gut microbial taxa and systemic TMAO levels and the possible TMAO contribution to incident post-STEMI cardiovascular events. PATIENTS AND METHODS: A total of 60 patients, including 30 with unstable angina pectoris (UAP), 30 post-STEMI and 30 healthy controls, were enrolled from June to November 2017. Metagenomic sequencing was performed and TMAO and IL-6 were detected. RESULTS: Minimal discriminators of gut microbial taxa (top 40) distinguished ACS patients from controls. Serum TMAO levels were positively associated with increased abundance of Aerococcaceae, Ruminococcaceae_UCG.005, Ruminococcaceae_UCC.014 and X. Eubacterium_fissicatena, and decreased abundance of Lachnospiraceae_FCS020 (P < 0.05). Elevated serum TMAO levels correlated independently with ACS (P < 0.05). Risk stratification for incident major adverse cardiovascular events (MACE) improved at one year in patients with serum TMAO levels ≦2.19 µM. Serum interleukin-6 levels were not significantly increased in patients with ACS and post-STEMI MACE. CONCLUSIONS: ACS and incident post-STEMI MACE may be associated with the gut bacteria choline metabolite TMAO. The specific gut microbial taxa identified in association with serum TMAO levels may be potential predictive biomarkers for accurate diagnosis of ACS onset.
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Gao et al. (2020) conducted an observational in Acute Coronary Syndrome (ACS) (n=90). Gut microbial taxa and serum TMAO levels vs. Healthy controls or low TMAO levels was evaluated on Serum TMAO levels in ACS patients compared to healthy controls (p=<0.001). Elevated serum TMAO levels and specific gut microbial taxa were significantly associated with acute coronary syndrome, although the association with 1-year post-STEMI cardiovascular events was not statistically significant.
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