Association Of Gut Microbiome With Coronary Heart Disease

Background and PurposeCoronary heart disease is one of the most common chronic diseases and causes of death.It is currently believed that coronary heart disease is the result of multiple factors acting together and superimposing each other,and its pathogenesis is not yet clear.More and more evidence shows that the metabolites of gut microbiome are closely related to the development of coronary heart disease,and there is little research on the role of intestinal microorganisms in different clinical subtypes of coronary heart disease.Therefore,this study intends to explore the changes in the composition and abundance of intestinal flora in patients with different clinical subtypes of coronary heart disease and its predictive value for cardiovascular risk,as to provide new references and ideas for the diagnosis and treatment of coronary heart disease.MethodsA total of 167 patients with coronary heart disease(including 48 patients with stable angina pectoris,48 patients with unstable angina pectoris,30 patients with non-ST-elevation myocardial infarction,and 41 patients with ST-elevating myocardial infarction)and 43 healthy controls were collected.Fresh feces samples were analyzed by 16SrDNA sequencing to analyze the differences in intestinal flora among patients with coronary heart disease and healthy people.Picrust software was used to predict the gene metabolism function of each group of bacteria.Analysis the correlation between clinical indicators of patients and metabolic function.Explore the correlation between GRACE scores and flora metabolism in patients with non-ST elevation acute coronary syndrome.Follow up major cardiovascular defects in patients,to explore the relationship between the occurrence of cardiovascular adverse events in patients and the metabolic function of intestinal flora,and provide new reference and ideas for the diagnosis and treatment of coronary heart disease.Results1.There was no statistically difference in the alpha diversity of the gut microbiome in the five groups of subjects(P>0.05),while the difference in beta diversity was statistically significant(P<0.001).2.On the level of phylum,Proteobacteria in the STEMI group were significantly higher than those in the control group(P<0.001),and Actinobacteria in the four disease groups were significantly higher than those in the control group(P<0.01).On the level of genus,the abundance of Streptococcus,Phascolarctobacterium,Escherichia,Atopobium and Actinomyces in the four CAD groups was significantly higher than that in the control group(P<0.05),while Sutterella,Anaerostipes,and Rothia were significantly decreased in the four CAD groups(P<0.05).Granulicatella in the NSTEMI and STEMI groups were significantly higher than those in the control group(P<0.01),and Klebsiella in the STEMI group(P<0.001)were significantly higher than those in the control group.Lachnospira in the UA group was significantly lower than the STEMI group(P<0.05),and Dialister in the STEMI group was significantly lower than the SA group(P<0.05)3.Staphylococcus aureus infection,apoptosis,and RIG.I-like receptors signaling pathways were significantly positively associated with the risk of death during hospitalization and three years after discharge in patients with non-ST elevation acute coronary syndrome(P<0.05).Apoptosis and RIG.I-like receptor signaling pathway were significantly positively related to the risk of death at six months of discharge in patients with non-ST elevation acute coronary syndrome(P<0.05),and apoptosis had a significant positive correlation with the one-year mortality risk at discharge(P<0.05).4.The risk ratio of major adverse cardiovascular events in patients with high-intensity alpha Linolenic acid metabolism was significantly lower than that in patients with low-intensity alpha Linolenic acid metabolism(P=0.002046,HR=0.173),and there was no statistical difference in the risk ratio in patients with other different metabolic functions.ConclusionThe intestinal flora of patients with coronary heart disease was significantly different from that of healthy people,and the bacterial flora in patients with different clinical subtypes of coronary heart disease was also significantly different.Microbial metabolic function in patients with non-ST elevation acute coronary syndrome was significantly associated with GRACE risk score.Patients with high alpha-Linolenic acid metabolism have fewer adverse cardiovascular events than those with low alpha-Linolenic acid metabolism.It is suggested that intestinal flora may become a potential marker and therapeutic intervention target for monitoring the occurrence and development of coronary heart disease,which provides a new basis for further research on the relationship between gut microbiome and coronary heart disease.