Gut microbiota-derived imidazole propionate predicts cardiometabolic risk in patients with coronary artery disease
Authors' conclusion
Gut microbiota-derived ImP predicted MACE in patients with CAD independently of traditional risk factors
Study context
- Population
- Patients with coronary artery disease (CAD): Acute coronary syndrome (ACS) (Swiss ACS, Swiss CMR, German ACS cohorts) and chronic coronary syndrome (German chronic coronary syndrome (CCS) cohort)independent prospective cohorts
- Exposure
- Circulating imidazole propionate levels and major adverse cardiovascular events (MACE)
- Outcome
- MACE:
- First occurrence of death
- Non-fatal MI
- Non-fatal stroke after admission
Methodological detailsmultiple independent cohorts, multivariable Cox models
- Multiple independent cohorts
- Multivariable Cox models
Main finding
As reported in the abstract
MACE
ImPHazard ratio (95% CI)P value
Swiss ACS cohort; per log2 increase; adjusted for established risk factors
1.22(1.10–1.35)
P < 0.001German ACS cohort; adjusted
2.34(1.46–3.76)
P < 0.001German CCS cohort; adjusted
1.32(1.13–1.53)
P < 0.001Per log2 increase, as printed
Observational data: associations, not effects.
Further findings
Mortality
| HR (95% CI) | P value | ||
|---|---|---|---|
| ImPSwiss ACS cohort; adjusted for established risk factors | 1.34 (1.17–1.54) | P < 0.001 | |
| ImPGerman ACS cohort; adjusted for established risk factors | 2.38 (1.48–3.82) | P < 0.001 | |
| ImPGerman CCS cohort; adjusted for established risk factors | 1.50 (1.14–1.98) | P = 0.004 | |
| 0.20.5125Hazard ratio (log scale) |
Predictive value beyond trimethylamine N-oxide
| HR (95% CI) | P value | ||
|---|---|---|---|
| Imidazole propionateSwiss ACS cohort | 1.30 (1.05–1.61) | P = 0.014 | |
| Imidazole propionateGerman CCS cohort | 1.31 (1.12–1.53) | P = 0.001 | |
| 0.512Hazard ratio (log scale) |
Original publication
Gut microbiota-derived imidazole propionate predicts cardiometabolic risk in patients with coronary artery disease. Eur Heart J. Published 30 August 2025. doi:10.
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