Clinical Study On The Adjuvant Treatment Of Unstable Angina With Bifid Triple Viable Capsules Dissolving At Intestines

Objective The aim of this study was to investigate the effects of adjuvant treatment with Bifid Triple Viable Capsules Dissolving at Intestines on the gut microbiota structure and abundance,Trimethylamine-N-oxide levels,and postoperative cardiovascular events in patients with unstable angina to explore new diagnostic and therapeutic approaches.Methods A total of 60 patients diagnosed with unstable angina based on clinical symptoms,coronary angiography results,and electrocardiograms,and who underwent coronary stent implantation between June 2021 and December 2021,were included in this study.They were divided into a control group(routine treatment group,n=30)and an observation group(routine treatment + Bifid Triple Viable Capsules Dissolving at Intestines treatment group,n=30).After discharge,the control group received routine treatment(decrease blood lipid,coronary dilation,and dual antiplatelet therapy),while the observation group was treated with Bifid Triple Viable Capsules Dissolving at Intestines orally(210 mg/capsule,3 capsules/time,2 times/day,for a total of 1 month: 30 days)in addition to routine treatment.Fecal and blood samples were collected from the control group before treatment(UA group)and the observation group before treatment(BFD group).After the 30-day treatment course,blood and fecal samples were collected from the control group after treatment(HL group)and the observation group after treatment(RC group).Blood samples were used to detect TMAO levels using targeted gene metabolomics,and the differences in TMAO levels between groups were compared.Fecal samples were analyzed using 16 S ribosomal DNA amplicon sequencing to investigate the gut microbiota structure characteristics in-depth.The incidence of cardiovascular adverse events at 1,6,and 12 months after discharge was collected and subjected to statistical analysis.Results 1.The species richness and diversity of the gut microbiota in the observation group after treatment(RC group)were higher than in the other groups;After treatment in the observation group(RC group),the Firmicutes/Bacteroidetes ratio was lower compared to the control group after treatment(HL group),the abundance of Bifidobacterium,Lactobacillus,Blautia was higher than that of the control group after treatment(HL group),and the abundance of Faecalibacterium,Alistipes,Roseburia was lower than that of the control group after treatment(HL group),with a statistically significant difference(P<0.05).2.Before treatment,there was no significant difference in TMAO concentrations between the observation group and the control group(P>0.05);after one month(30 days)of treatment,there was no change in TMAO concentrations in the control group,and the difference was not statistically significant(P>0.05);after one month(30 days)of treatment,in the observation group,the TMAO concentration decreased compared to before treatment,with a statistically significant difference(P<0.05);after treatment,the difference in TMAO concentrations between the two groups was statistically significant(P<0.05).3.compared to the control group,the observation group had a lower incidence of cardiovascular adverse events at 12 months after discharge,with a significant difference(P<0.05).Conclusion In patients with unstable angina,the use of Bifid Triple Viable Capsules Dissolving at Intestines as an adjunctive treatment can increase the richness and diversity of the gut microbiota,change the type and abundance of intestinal flora,and reduce the level of Trimethylamine-N-Oxide,a gut microbiota metabolite.To a certain extent,reduce the occurrence of major adverse cardiovascular events and altering the progression of unstable angina pectoris.