Comparison of thrombus, gut, and oral microbiomes in Korean patients with ST-elevation myocardial infarction: a case–control study

Abstract

ST-segment elevation myocardial infarction (STEMI) is characterized by thrombotic coronary artery occlusions caused by atherosclerotic plaque rupture. The gut microbiome potentially contributes to the pathogenesis of coronary artery diseases. This study investigated the microbial diversity and composition of coronary thrombi in STEMI patients and the composition of the thrombus microbiome relative to that of the oral and gut microbiomes. A case–control study was performed with 22 STEMI patients and 20 age- and sex-matched healthy controls. Coronary thrombi were acquired from STEMI patients via manual thrombus aspiration during primary coronary intervention. Oral swab and stool samples were collected from both groups, and 16S rRNA sequencing and metagenomic microbiome analyses were performed. Microbial DNA was detected in 4 of 22 coronary thrombi. Proteobacteria (p) and Bacteroidetes (p) were the most abundant phyla. The oral and gut microbiomes significantly differed between patients and healthy controls. The patient group presented microbial dysbiosis, as follows: a higher relative abundance of Proteobacteria (p) and Enterobacteriaceae (f) in the gut microbiome and a lower abundance of Firmicutes (p) and Haemophilus (g) in the oral microbiome. Furthermore, 4 significantly abundant genera were observed in the coronary thrombus in the patients: Escherichia, 1.25%; Parabacteroides, 0.25%; Christensenella, 0.0%; and Bacteroides, 7.48%. The present results indicate that the relative abundance of the gut and oral microbiomes was correlated with that of the thrombus microbiome.

Comparison of Microbial Populations in the Blood of Patients With Myocardial Infarction and Healthy Individuals

“…A similar result was found by Kamo et al ( 2017 ) regarding the gut microbiota in heart failure patients and HC subjects (Mayerhofer et al, 2020 ). The beta diversity values of the gut, oral, and thrombus microbiomes were found to be significantly different in Korean patients with ST-elevation myocardial infarction (Kwun et al, 2020 ). Particularly, the results of this study revealed partial separation between both groups.…”

Dapagliflozin modulates the faecal microbiota after myocardial infarction in non‐diabetic mice

“…Proteobacteria are seen to increase in the faecal microbiota of patients with ST‐segment elevation myocardial infarction (STEMI) 30 . Desulfovibrionaceae belonged to the phylum Proteobacteria (Delta) 31 .…”

“…**p ≤ 0.01, ***p ≤ 0.001, ****p ≤ 0.0001, for MI + DAPA vs MI group. ## p ≤ 0.01, #### p ≤ 0.0001, for Sham vs MI group Proteobacteria are seen to increase in the faecal microbiota of patients with ST-segment elevation myocardial infarction (STEMI) 30.…”

Comparative characterization of inflammatory profile and oral microbiome according to an inflammation-based risk score in ST-segment elevation myocardial infarction

“…In MI patients, microorganisms belonging to the oral microbiota, such as Lactobacillus, Bacteroidetes , and Streptococcus , have been isolated from the bloodstream. Likewise, a high proportion of the phyla Proteobacteria and Bacteroidetes is found in thrombus samples ( Zhou et al., 2018 ; Koren et al., 2011 ; Kwun et al., 2020 ). Increasing studies evaluated the interplay between the microbiota of the oral cavity and the intestine.…”

“…In one study, the genera Veillonella and Streptococcus were identified in samples analyzed from three different niches, oral cavity, intestine, and atherosclerotic plaque from the same patient ( Koren et al, 2011 ). Likewise, in STEMI patients, alterations of the gut microbiota (GM) have been described, characterized by an increase in Bacteroides and Prevotella , as well as changes related to a greater GM diversity associated with clinical characteristics of poor oral health ( Kwun et al., 2020 ; Xu et al., 2021 ; Yin et al., 2015 ; Gao et al., 2020 ).…”