Lactobacillus levels and prognosis of patients with acute myocardial infarction

作     者：Jing-Jing CAI Yin LIU Jie WANG Jing-Xian WANG Yuan WANG Shi-Bo XU Zhuang CUI Jing GAO 

作者机构：Graduate SchoolTianjin Medical UniversityTianjinChina Department of CardiologyXing’anmeng People’s HospitalInner MongoliaChina Clinical School of ThoracicTianjin Medical UniversityTianjinChina Department of CardiologyTianjin Chest HospitalTianjinChina School of Public HealthTianjin Medical UniversityTianjinChina Cardiovascular InstituteTianjin Chest HospitalTianjinChina 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2022年第19卷第2期

页      面：101-114页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by the Key Project of Scientific and Technological Support Plan of Tianjin in 2020(No.20YFZCSY00820) the Major Science and Technology Projects of Tianjin Science and Technology Commission in 2016(No.16ZXMJSY00150) the Key Project of Healthcare Industry of Tianjin in 2016(No.16KG131)。 

主　　题：patients infarction prognosis 

摘      要：OBJECTIVE To explore the relationship between Lactobacillus and prognosis of acute myocardial infarction(AMI)patients treated by percutaneous coronary intervention(PCI)and its correlation with clinical parameters.METHODS Consecutive patients with AMI in the coronary care unit of Tianjin Chest Hospital in China who received emergency PCI between July 2017 and December 2018 were enrolled.Subjects’fecal 16 S r DNA gene sequencing data were analyzed and subjects were categorized into low,medium and high level groups according to stool Lactobacillus measurements.The primary endpoints were major adverse cardiac events.Cox regression analysis was used to analyze the relationship between Lactobacillus and prognosis.Spearman correlation analysis and trend tests were used to assess the relationship between Lactobacillus and the clinical indicators.RESULTS The data of 254 patients were included in the analysis.Mean age was 65.90±11.56 years,and 152 patients(59.84%)were male.Follow-up time was 652(548.25-753.00)days.Multivariate Cox regression analysis showed a significantly lower risk of major adverse cardiac events in patients with Lactobacillus7.1 copies/g[adjusted hazard ratio(HR)=0.216,95%CI:0.094-0.493,P0.001]compared to patients with Lactobacillus≤3.6 copies/g.Statistically significant differences were shown in ST-segment elevation myocardial infarction(STEMI)(HR=0.217,95%CI:0.085-0.551,P=0.001).Lactobacillus was a protective factor for male smokers aged over 60 years whose brain natriuretic peptide was over 1,000 pg/m L.Spearman correlation analysis showed that Lactobacillus correlated negatively with white blood cells,neutrophils,high-sensitivity C-reactive protein,Troponin T,creatine kinase,creatine kinase-MB and brain natriuretic peptide(downward trend),and correlated positively with left ventricular ejection fraction(upward trend).CONCLUSIONS This study is the first to reveal the correlation between Lactobacillus and inflammation and myocardial damage after STEMI.STEMI patients,especially male smokers aged over 60 years with severe impairment of cardiac function,have better outcomes with high levels of Lactobacillus,suggesting new therapeutic strategies for improving the prognosis and quality of life of AMI patients.