Coronary disease & ACS

Atlas of gut microbe-derived products from aromatic amino acids and risk of cardiovascular morbidity and mortality

Eur Heart JPublished Prospective cohort study

Authors' conclusion

Key gut microbiota-generated metabolites derived from aromatic amino acids independently associated with incident adverse cardiovascular outcomes are identified

Study context

Population
Sequential subjects undergoing elective diagnostic cardiac evaluationtwo independent cohorts
Participants
4,000 vs 833
Exposure
US vs EU
  • USn = 4,000
  • EUn = 833
Outcome
Incident MACE (MI, stroke or death) and all-cause mortality
Follow-up
3-year
Methodological detailstwo independent cohorts, stable isotope dilution mass spectrometry, Metabolites also measured in plasma from humans and mice before vs after poorly absorbed antibiotics to suppress gut microbiota
  • Two independent cohorts
  • Stable isotope dilution mass spectrometry
  • Metabolites also measured in plasma from humans and mice before vs after poorly absorbed antibiotics to suppress gut microbiota

Main finding

As reported in the abstract

  • Multiple aromatic amino acid-derived metabolites originating at least in part from gut bacteria associated with incident major adverse cardiovascular event (MACE) and all-cause mortality, independent of traditional risk factors
  • Phenylacetyl glutamine and phenylacetyl glycine (from phenylalanine) associated with incident MACE and poorer survival
  • P-cresol (from tyrosine), yielding p-cresol sulfate and p-cresol glucuronide, associated with incident MACE and poorer survival
  • 4-OH-phenyllactic acid (from tyrosine), yielding 4-OH-benzoic acid and 4-OH-hippuric acid, associated with incident MACE and poorer survival
  • Indole (from tryptophan), yielding indole glucuronide and indoxyl sulfate, associated with incident MACE and poorer survival
  • Indole-3-pyruvic acid (from tryptophan), yielding indole-3-lactic acid and indole-3-acetyl-glutamine, associated with incident MACE and poorer survival
  • 5-OH-indole-3-acetic acid (from tryptophan) associated with incident MACE and poorer survival
  • Independent of traditional risk factors

Observational data: associations, not effects.

Original publication

Atlas of gut microbe-derived products from aromatic amino acids and risk of cardiovascular morbidity and mortality. Eur Heart J. Published 21 June 2023. doi:10.1093/eurheartj/ehad333

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