Distinct microbial and metabolic shifts characterize acute coronary syndrome and recovery

作者：Jing Xu, Die Dai, Yanan Yang, Yanan Yang, Shan Gao, Jingang Yang, Chaoran Dong, Weixian Yang, Jiansong Yuan, Tianjie Wang, Tao Tian, Yanmin Yang, Yanmin Yang, Fang Luo, Ping Jiang, Chao Wu, Chao Wu, Xiaolu Sun, Yong‐Gang Sui, Guofeng Gao, Wentao Ma, Wu Yuan, Jun Zhang, Jia Li, Chao Guo, Cheng Cui, Tingting Guo, Xueyan Zhao, Jinqing Yuan, Shubin Qiao, Fenghuan Hu, Xiaojin Gao, Xiaoliang Luo, Haoran Peng, Daoming Wang, Jiqiu Wu, Chongming Wu, Chongming Wu, Jiuming He, Wei‐Hua Chen, Yuejin Yang, Yuejin Yang, Jingyuan Fu · 发表于：iMeta · 年份：2025 · DOI：10.1002/imt2.70079 · 被引用次数：5 · 研究领域：Diet and metabolism studies、Cardiac Health and Mental Health、Tryptophan and brain disorders

Abstract Early identification of patients at risk of acute coronary syndrome (ACS) remains a major unmet need, particularly among those with stable coronary artery disease (sCAD), where timely intervention could markedly improve outcomes. The gut microbiota has been implicated in coronary artery disease (CAD), but its ability to distinguish ACS from sCAD is not well defined. Here, we performed cross‐sectional multi‐omics profiling of fecal microbiota and plasma metabolites in 548 individuals, including participants with normal coronary arteries ( N = 175), primary sCAD ( N = 161), and ACS ( N = 212). To assess whether disease‐associated changes resolve with treatment, we further analyzed an independent cohort of ACS patients ( N = 52) who transitioned to sCAD following standard therapy. We identified profound ACS‐associated alterations in gut microbial composition and systemic metabolism, marked by enrichment of pro‐inflammatory taxa such as Streptococcus spp. and elevated circulating levels of 3‐hydroxybutyrate (3‐HB). Strikingly, many of these ACS‐specific microbial and metabolic signatures, including 3‐HB and related microbial functional pathways, were restored toward sCAD‐like levels after clinical recovery. Integrative models combining microbial taxa, metabolites, and clinical biomarkers robustly discriminated ACS from healthy controls (AUC = 0.91) and from sCAD (AUC = 0.83), significantly outperforming clinical markers alone (AUC = 0.69 for NCA vs. ACS; 0.59 for sCAD vs...