Human Gut Microbiota in Coronary Artery Disease: A Systematic Review and Meta-Analysis

Abstract

In recent years, the importance of the gut microbiome in human health and disease has increased. Growing evidence suggests that gut dysbiosis might be a crucial risk factor for coronary artery disease (CAD). Therefore, we conducted a systematic review and meta-analysis to determine whether or not CAD is associated with specific changes in the gut microbiome. The V3–V4 regions of the 16S rDNA from fecal samples were analyzed to compare the gut microbiome composition between CAD patients and controls. Our search yielded 1181 articles, of which 21 met inclusion criteria for systematic review and 7 for meta-analysis. The alpha-diversity, including observed OTUs, Shannon and Simpson indices, was significantly decreased in CAD, indicating the reduced richness of the gut microbiome. The most consistent results in a systematic review and meta-analysis pointed out the reduced abundance of Bacteroidetes and Lachnospiraceae in CAD patients. Moreover, Enterobacteriaceae, Lactobacillus, and Streptococcus taxa demonstrated an increased trend in CAD patients. The alterations in the gut microbiota composition are associated with qualitative and quantitative changes in bacterial metabolites, many of which have pro-atherogenic effects on endothelial cells, increasing the risk of developing and progressing CAD.

Intestinal microbiota and metabolome perturbations in ischemic and idiopathic dilated cardiomyopathy

“…While Firmicutes , Proteobacteria , Bacteroidota, and Fusobacteriota were dominant in IDCM. Notably, Actinobacteria exhibited lower abundance in ICM patients compared to HC, consistent with prior research [ 30 , 31 ]. In contrast, the Proteobacteria phylum was notably increased in both DCM groups, which is noteworthy due to its potential role in immune dysfunction, inflammatory diseases, and metabolic disorders [ 32 , 33 ].…”

Addressing the Missing Links in Cardiovascular Aging

“… 16 A recent meta-analysis highlighted differences in the gut microbiota composition in coronary artery disease patients compared to healthy controls with strikingly low ratios of the Phyla Bacteroides. 17 Furthermore, the abundance of a genus of bacteria called Bifidobacterium in the microbiome that is most abundant in childhood declines with age. It has shown to up-regulate anti-inflammatory pathways and even sequester heavy metals balancing the microbiome.…”

Gut Microbiota and Microbial Metabolism in Early Risk of Cardiometabolic Disease

“…293 Microbiota, as assessed through microbiome composition, have been implicated in multiple cardiovascular diseases, including pulmonary arterial hypertension, 294 abdominal aortic aneurysm, 295 heart failure, 296 heart failure with preserved ejection fraction, 297 heart failure with reduced ejection fraction, 298 and coronary artery disease. 299 However, most studies have included relatively small sample sizes, with little or no replication, leaving considerable uncertainty surrounding the clinical or mechanistic relevance of specific findings. While some of these associations are likely mediated by microbial metabolites and effects on inflammation, lipid metabolism, and vascular function, as discussed previously, 179,196,284 the specific pathways linking microbiota to individual CVDs remain to be established.…”