Patterns of Circulating Microbiota during the Acute Phase Following ST-Segment Elevation Myocardial Infarction Predict Long-Term Cardiovascular Events A Prospective Cohort Study

Limited information exists regarding whether circulating microbiota could predict long-term clinical out-comes following ST-segment elevation myocardial infarction (STEMI). A total of 244 consecutive patients with STEMI were followed for 2.8 years, and 64 first major adverse cardiovascular events (MACEs) were recorded. Both microbiota abundance [Corynebacterium tuberculostearicum (HR, 1.28; 95% CI, 1.03-1.58) and Staphylo-coccus aureus (S. aureus) (HR, 1.16; 95% CI, 1.02-1.33)] and microbiota clusters (Cluster 2 versus Cluster 1: HR, 1.84; 95% CI, 1.04-3.27) could independently predict MACE. Furthermore, a model based on established independent predictors alone was significantly improved by the addition of different microbiota patterns. In ad-dition, CD14++CD16+ monocytes (Mon2) had a significant mediation effect on the microbiota patterns & RARR; MACE association. The present study demonstrated that the abundance and clusters of circulating microbiota are associated with future adverse cardiovascular events independent of traditional risk factors, which were par-tially mediated by an increase in Mon2.(Int Heart J 2023; 64: 551-561)