Gut microbiota-derived imidazole propionate predicts cardiometabolic risk in patients with coronary artery disease

作者：Florian A. Wenzl, Peizhi Wang, Florian Kahles, Katharina R. Beck, Evangelos Giannitsis, Slayman Obeid, Francesco Bruno, Xinmin S. Li, David Nanchen, Luca Liberale, Maria Anna Smolle, Victor Schweiger, Roland Klingenberg, Robert Manka, Barbara E. Stähli, Christian Templin, Maximilian König, Jinqing Yuan, Mustafa Yı́ldı́rı́m, Michael Lehrke, Arnold von Eckardstein, Nikolaus Marx, François Mach, Lorenz Räber, Hugo A. Katus, Elisabeth Steinhagen–Thiessen, Ilja Demuth, John Deanfield, Peter Libby, Stanley L. Hazen, Arash Haghikia, Ulf Landmesser, Fredrik Bäckhed, T F Luescher · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf661 · 被引用次数：10 · 研究领域：Gut microbiota and health、Immune responses and vaccinations、Cardiac Health and Mental Health

BACKGROUND AND AIMS: The gut microbiota is a modulator of cardiometabolic disease. Circulating imidazole propionate (ImP) is a microbiota-derived proatherogenic amino acid metabolite modulating the inflammatory response of myeloid cells, endothelial function and glucose metabolism. This study examined the prognostic value of ImP in patients with coronary artery disease (CAD). METHODS: Circulating ImP levels were measured in independent prospective cohorts of patients with acute coronary syndrome (ACS, Switzerland n=4937, Germany n=1497) and chronic coronary syndrome (CCS, Germany n=701). Major adverse cardiovascular events (MACE), defined as the first occurrence of a composite of death, nonfatal myocardial infarction, or nonfatal stroke after admission, were the primary endpoint. Cox models, accounting for established risk factors including the gut-derived cardiovascular risk factor trimethylamine N-oxide (TMAO), were used to evaluate the predictive value of ImP. RESULTS: Circulating ImP was associated with more advanced CAD and with cardiometabolic characteristics including diabetes and elevated high-sensitivity C-reactive protein. High ImP was an independent predictor of MACE (Swiss ACS cohort: hazard ratio [HR] per log2 increase 1.22, 95% confidence interval [CI] 1.10-1.35, P<0.001; German ACS cohort: HR 2.34, 95% CI 1.46-3.76, P<0.001; German CCS cohort: HR 1.32, 95% CI 1.13-1.53, P<0.001) and of mortality (Swiss ACS cohort: HR 1.34, 95% CI 1.17-1.54, P<0.001; German ACS ...