Human Gut Microbiota in Coronary Artery Disease: A Systematic Review and Meta-Analysis †
Abstract
:1. Introduction
2. Materials and Methods
2.1. Systematic Review
2.1.1. Search Strategy
2.1.2. Inclusion and Exclusion Criteria
2.1.3. Assessment of Eligibility and Data Extraction
2.2. Meta-Analysis
2.2.1. Readings Preparation and zOTU Picking
2.2.2. Differential Abundance Testing
2.2.3. Statistical Analysis
3. Results
3.1. Characteristics of Included Studies
3.2. Systematic Review Results
RoB NOS | 7 | 10 | 7 | 10 | 8 |
Diversity α β | − | No data | + | + | No data |
− | No data | − | + | No data | |
Major outcome- CAD relative abundance | Bacteroidales▼ Gammaproteobacteria▲ Enterobacteriaceae▲ Prevotella ▲ | Lactobacillales▲ Bacteroides▼ | Gammaproteobacteria▲ Firmicutes▼ Lactobacillales▼ Enterobacteriaceae ▲ Lachnospiraceae▼ Prevotella▼ Bacilli▼ Christensellaceae▲ Prevotellaceae ▼ | Bacteroidetes▲ Firmicutes ▼ Bacteroidales▲ Coriobacteriales▲ Christensellaceae▲ Prevotellaceae▲ | Enterobacteriaceae ▲ Escherichia/Shigella ▲ |
Major exclusion criteria | patients less than 19 years, pregnancy abnormal kidney function | Patients with systemic diseases: hepatic, renal, collagen, malignancy | other identifiable etiologies of coronary thrombi, active infection during admission. | heart failure, structural heart disease, history of antibiotic use within 1 month, serious dysfunction of liver or kidney | antibiotics, probiotics, decompensated chronic diseases, oncological diseases |
Major inclusion criteria CAD Control | No prior heart attacks or strokes, and no antibiotic use within three months before enrollment | -coronary risk factors: hypertension, diabetes, and/or dyslipidemia, | no previous history of cardiovascular disease, no evidence of active infection | coronary arteries without stenosis | over 50 years, without cardiovascular disease and acute or acute exacerbations of chronic diseases |
acute coronary syndrome (STEMI or NSTEMI) | -stable angina pectoris, old myocardial infarction, PCI or CABG for m in 6 months interval | ECG criteria of STEMI, angiographically proven coronary thrombi | ≥50% stenosis in at least one main coronary artery | CAD confirmed by anamnestic data, results of daily ECG Holter monitoring, coronary angiography. | |
Sample size | CAD 19 Ctrl 19 | CAD 39 Ctrl 30 | CAD 22 Ctrl 20 | CAD 186 Ctrl 123 | CAD 29 Ctrl 30 |
Technique | 16S rRNA Illumina MiSeq | T-RFLP | 16S rRNA V3-V4 Illumina Miseq | 16S rRNA V3-V4 Illumina MiSeq | 16S rRNA V3-V4 Illumina MiSeq |
Study design | Case-control | Cross-sectional | Case-control | Cross-sectional | Cross-sectional |
First author/year | Alhmoud T., et al. [38] 2019 | Emoto T., et al. [39] 2016 | Kwun J., et al. [40] 2020 | Zheng Y, et al. [41] 2020 | Ivashkin, V., et al. [42] 2019 |
RoB NOS | 7 | 9 | 8 | 9 | 7 |
Diversity α β | No data | No data | + | No data | No data |
No data | − | − | − | No data | |
Major outcome- CAD relative abundance | Bacteroidetes ▼ Lactobacillales ▲ | Escherichia coli ▲ R. gnavus ▲ Bacteroides ▼ Streptococcus ▲ | Enterococcus ▲ Lactobacillus ▲ Bacteroides ▼ Fusobacterium ▼ Dorea ▼ Streptococcus ▼ | Bacteroides vulgatus ▼ Bacteroides dorei ▼ Faecalibacterium ▲ prausnitzii Prevotella copri ▲ | Bacteroides ▼ |
Major exclusion criteria | acute coronary syndrome systemic disease, including hepatic, renal, collagen disease and malignancy, antibiotic treatment | ongoing infectious diseases, cancer, renal, or hepatic failure, stroke, use of antibiotics within 1 month of sample collection. | kidney dialysis acute infection, gastrointestinal diseases cancer, treatments with antibiotics or probiotics within one month | Patients with: acute coronary syndrome, with systemic disease: including hepatic, renal, collagen disease and malignancy, antibiotics | heart failure, renal and hepatic disease, malignancies, inflammatory disease |
Major inclusion criteria CAD Control | no history of coronary or another vascular disease, no symptoms indicating angina, no ischemic abnormality in ECG | asymptomatic, no history of CAD, renal failure, systemic disease, and stroke | No data | Patients with coronary risk factors: hypertension, diabetes, dyslipidemia Without a present or past history of coronary or other vascular diseases | Patients with coronary risk factors |
stable angina, old myocardial infarction, PCI or CABG at least 6 months interval, 75% stenosis of coronary artery | confirmed by coronary angiography, and ≥50% stenosis in single or multiple vessels | coronary angiography or coronary computed tomography angioplasty | stable angina, old myocardial infarction, PCI or CABG ≥ 6 months before the present study. >75% stenosis. | CAD confirmed by a coronary angiography | |
Sample size | CAD 39 Ctrl 50 | CAD 218 Ctrl 187 | CAD 67 Ctrl 17 | CAD 30 Ctrl 30 | CAD 11 Ctrl 10 |
Technique | T-RFLP | Shotgun sequen- cing | 16S rRNA V4-V5 Illumina Miseq | 16S rRNA V3-V4 Illumina MiSeq | 16S rRNA V3-V4 Illumina MiSeq |
Study design | Case-control | Cross-sectional | Cross-sectional | Cross-sectional | Cross-sectional |
First author/year | Emoto T. et al. [43] 2016 | Jie Z.,et al. [44] 2017 | Liu Z., et al. [45] 2019 | Yoshida N. et al. [46] 2018 | Yoshida N., et al. [47] 2019 |
RoB NOS | 10 | 10 | 7 | 9 | |
Diversity α β | + | + | No data | + | |
+ | + | + | + | ||
Major outcome- CAD relative abundance | Bacteroides ▼ Escherichia ▼ Desulfovibrio ▲ Parabacteroides ▲ Streptococcus ▲ Lacobacillus ▲ | Gamaaproteobacteria ▲ Enterobacteriaceae ▲ Prevotellaceae ▼ Escherichia-Shigella ▲ Fusobacterium ▲ Streptococcus ▲ Bacilli ▼ Lactobacillus ▼ Lactobacillales ▼ Coriobacteriales ▲ | Ruminococcus Gnavus ▲ Lachnospiraceae ▼ Ruminococcus Gauvreauii group ▼ | Bacteroidetes ▼ Bacteroidia ▼ Bacilli ▲ Gammaproteobacteria ▲ Bacteroidales ▼ Lactobacillales ▲ | |
Major exclusion criteria | No history of unstable angina, myocardial infarction, stroke, cancers, coronary revascularization. | history of GIT surgery or organic disease, history of stroke, hypertension, diabetes, kidney disease infection within one the month of the study or the use of a probiotic, antacid, antibiotic | prior gastrointestinal surgery, the current administration of antibiotics or probiotics, history of IBD or auto-immune diseases, | history of acute or chronic intestinal disease, active cancer aged below 30 and over 80, history of acute coronary syndrome or typical angina (HC) | |
Major inclusion criteria CAD Control | Without significant stenosis in coronary arteries | healthy volunteers from the hospital health examination center | abnormal peripheral endothelial dysfunction without CAD based on clinical history, non-invasive stress testing, and coronary imaging studies | randomly selected. sex and age-matched to CAD group, without CAD | |
SA and AMI criteria. The coronary angiography was performed on all patients. | coronary angiography, ECG changes | history of PCI or CABG, coronary arteries diagnosed by coronary angiography or computed tomography coronary angiography | aged 30–79, hospitalization 12–18 months before the evaluation for elective PCI ACS: STEMI, NSTEMI, UA | ||
Sample size | CAD 141 Ctrl 49 | CAD 60 Ctrl 30 | CAD 88 Ctrl 114 | CAD 169 Ctrl 166 | |
Technique | 16S rRNA Illumina HiSeq | Phusion High-Fidelity PCR Master Mix | 16S rDNA IM-TORNADO | 16S rRNA | |
Study design | Cross-sectional | Cross-sectional | Cross-sectional | Cross-sectional | |
First author/year | Dong Ch,, et al., 2021 preprint [48] | Gao J., et al. [49] 2020 | Toya T, et al. [50] 2021 | Sawicka- Śmiarowska et al. [27] 2021 | |
RoB NOS | 10 | 10 | 10 | 10 | |
Diversity α β | + | No data | + | + | |
− | + | + | + | ||
Major outcome- CAD relative abundance | Prevotellaceae ▲ Fusobacterium ▼ Bacteroides ▼ Parabacteroides ▲ | Lachnospiraceae ▼ R. gnavus ▲ | Firmicutes ▲ Bacteroides ▼ Bacteroidetes ▼ Bacteroidia ▲ | Bacteroides ▼ Bacilli ▲ Firmicutes ▼ Gammaprotebacteria ▲ Lachnospiracea ▼ Escherichia-Shigella ▲ Lactobacillus ▲ Bacteroidia ▼ Lactobacillales ▲ Bacteroidales ▼ Coriobacteriales ▲ Christensellaceae ▼ Streptococcus ▲ | |
Major exclusion criteria | IBD, hepatitis B or cirrhosis, cancer, organ failure, exposure to probiotics or prebiotics within one month; receiving treatment with antibiotics, | gastrointestinal surgery, current administration of antibiotics and a probiotic, history of IBD and auto-immune diseases | probiotics, antibiotics within a month before sample gastrointestinal surgery;history of alcohol abuse, diabetes, gastrointestinal disease | cancer, infectious diseases: IBD, antibiotic or probiotic consumption within 1 month before sample collection | |
Major inclusion criteria CAD Control | participants with no evidence of stenosis in the coronary artery | healthy volunteers, normal or <50% stenosis in coronary arteries | healthy volunteers | no history of CAD and other diseases from the exclusion criteria | |
coronary angiography, >50% stenosis | ≥50% stenosis in at least one main coronary artery, patients with ACS | CAD confirmed by coronary angiography and CABG or PCI, residents of southern China, 50–85 years. | CAD confirmed by a coronary angiography | ||
Sample size | CAD 45 Ctrl 19 | CAD 53 Ctrl 53 | CAD 29 Ctrl 34 | CAD 70 Ctrl 98 | |
Technique | 16S rRNA V4 Ion Torrent | 16S rDNA V3-V5 IM-Tornado | 16S rRNA V3-V5 Illumina Miseq | 16S rRNA V4 Illumina MiSeq | |
Study design | Cross-sectional | Cross-sectional | Cross-sectional | Cross-sectional | |
First author/year | Hu Jl, et al. [51] 2021 | Toya T, et al. [52] 2020 | Cui L., et al. [53] 2017 | Zhu Q.et al. [54] 2018 | |
RoB NOS | 9 | 7 | 7 | ||
Diversity α β | + | No data | No data | ||
+ | + | No data | |||
Major outcome- CAD relative abundance | Firmicutes ▲ Bacteroides ▲ Bacteroidetes ▼ Gammaproteobacteria ▲ Bacteroidia ▼ Desulfovibrio ▲ Prevotella ▼ Bacteroidales ▼ Christensellaceae ▲ | Lachnospiraceae▼ | Bacteroidetes ▼ Bacteroidales ▼ Coriobacteriales ▲ | ||
Major exclusion criteria | antibiotics, probiotics, or prebiotics for at least 3 months before sampling, acute and chronic inflammatory diseases, tumors | Prior gastrointestinal surgery, the current administration of antibiotics, IBD, malignancy, auto-immune disease | renal disease, malignancy, ongoing infectious disease, hepatic disease, use of antibiotics within four weeks before sample collection. | ||
Major inclusion criteria CAD Control | Tibetan native residents family members of the patients | Without CAD based on clinical history, non-invasive stress testing, and coronary imaging studies | healthy volunteers | ||
Tibetan native residents coronary artery stenosis >50% ages 40–70 years | typical symptoms, the ECG pattern, cardiac enzyme raise, coronary angiography | CAD confirmed by coronary angiography, and patients with ≥50% stenosis in single or multiple vessels | |||
Sample size | CAD 18 Ctrl 23 | CAD 19 Ctrl 25 | CAD 15 Ctrl 15 | ||
Technique | 16S rRNA regions Illumina Hiseq | 16S rRNA V3-V4 Illumina Miseq | 16S rRNA V3-V4 Illumina Miseq | ||
Study design | Cross-sectional | Case-control study | Cross-sectional | ||
First author/year | Liu F. et al., 2020 [55] | Chiu et al., 2022 [56] | Choroszy et. al. [57] 2022 |
3.3. Meta-Analysis Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Choroszy, M.; Litwinowicz, K.; Bednarz, R.; Roleder, T.; Lerman, A.; Toya, T.; Kamiński, K.; Sawicka-Śmiarowska, E.; Niemira, M.; Sobieszczańska, B. Human Gut Microbiota in Coronary Artery Disease: A Systematic Review and Meta-Analysis. Metabolites 2022, 12, 1165. https://doi.org/10.3390/metabo12121165
Choroszy M, Litwinowicz K, Bednarz R, Roleder T, Lerman A, Toya T, Kamiński K, Sawicka-Śmiarowska E, Niemira M, Sobieszczańska B. Human Gut Microbiota in Coronary Artery Disease: A Systematic Review and Meta-Analysis. Metabolites. 2022; 12(12):1165. https://doi.org/10.3390/metabo12121165
Chicago/Turabian StyleChoroszy, Marcin, Kamil Litwinowicz, Robert Bednarz, Tomasz Roleder, Amir Lerman, Takumi Toya, Karol Kamiński, Emilia Sawicka-Śmiarowska, Magdalena Niemira, and Beata Sobieszczańska. 2022. "Human Gut Microbiota in Coronary Artery Disease: A Systematic Review and Meta-Analysis" Metabolites 12, no. 12: 1165. https://doi.org/10.3390/metabo12121165