Coronary disease & ACSCohort study
Atlas of gut microbe-derived products from aromatic amino acids and risk of cardiovascular morbidity and mortality
- Prospective cohort study
- 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
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
Main finding
As reported in the abstract
Incident MACE and all-cause mortality
- 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
Summarised from the published abstract; every number is checked against it