A marker of a gut microbiota metabolism may well be clinically useful in predicting the risk of acute coronary syndromes, Swiss researchers reported yesterday.
Professor Thomas Luscher of the University Heart Centre, Zurich, Switzerland, and his team reported in the European Heart Journal that recent studies highlight the role of gut microbes in the pathogenesis of both atherosclerotic heart disease and its adverse thrombotic events.
In particular, a plasma metabolite of gut bacteria activity called trimethylamine N-oxide has been shown in numerous studies to be linked to cardiovascular risks in a range of participant groups.
The team looked at this possible link in participants with acute coronary syndromes.
They used information from two sets of patients, 530 individuals with chest pain of suspected cardiac origin, and 1,683 acute coronary syndrome patients who underwent coronary angiography.
The first group showed a significant link between raised trimethylamine N-oxide on hospital admission and risk of major adverse cardiac events over the next 30 days, and the following seven years.
The same link was seen for risk over the following year in the second patient group, and was even predictive of future risk among those who did not have the troponin T protein in their blood, which indicates damage to the heart muscle.
They write: "Plasma trimethylamine N-oxide levels among patients presenting with chest pain predict both near- and long-term risks of incident cardiovascular events, and may thus provide clinical utility in risk stratification among subjects presenting with suspected acute coronary syndrome."
Higher levels of this metabolite have previously been linked to thrombosis and inflammation of blood vessels, the researchers say.
Xinmin, S. Li et al. Gut microbiota-dependent trimethylamine N-oxide in acute coronary syndromes: a prognostic marker for incident cardiovascular events beyond traditional risk factors. European Heart Journal 11 January 2017; doi: 10.1093/eurheartj/ehw582
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