gut microbiota
atrial fibrillation
coronary artery disease

How to Cite



The aim: To estimate gut microbiota composition peculiarities in patients with coronary artery disease (CAD) and atrial fibrillation (AF) and to evaluate their connections with known cardiometabolic risk factors (CRF).

Materials and methods: 300 patients formed 3 groups: I group – 149 CAD patients without rhythm disorders, II group – 124 patients with CAD and AF paroxysm and control group (CG) – 27 patients without CAD and arrhythmias. 16-S rRNA sequencing checked gut microbiota composition. CRF which was explored are total cholesterol (TC), triglycerides (TG), low density lipoproteins (LDL), high density lipoproteins (HDL), lipoprotein α (Lpα), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), C-reactive protein (CRP), interleukin-6 (IL-6), trymetilamine (TMA) and trymetilamine-N-oxide (TMAO).

Results: The significant changes of gut microbiota composition were found in CAD patients with AF paroxysm in comparison with CAD patients without arrythmia as increasing Actinomycetota phulum (P<0.05); increasing Actinobacter Spp. and decreasing Blautia Spp., Roseburia Inulinivorans, Bacteroides Thetaiotaomicron (P<0.05). Moreover, Actinobacter Spp., Akkermansia Muciniphila, Streptococcus Spp., Bacteroides Thetaiotaomicron, Bifidobacterium Spp. have the highest amount of significant correlations with CRF (body mass index, LDL levels; P<0.05). By the ROC-analysis we found the acceptable role of Lactobacillus Spp., Bifidobacterium Spp., Bacteroides Thetaiotaomicron, Blautia Spp., Actinobacter Spp. and Eubacterium Rectale in AF paroxysm occurrence in CAD patients (area under ROC-curve (AUC)<0.7). We found gut microbiota combinations with highest AUC for AF paroxysm in CAD patient: all of them include Actinobacter Spp (Actinobacter Spp. + 0.32 * Streptococcus Spp., AUC = 0.9008; 1.56 * Actinobacter Spp. – Blautia Spp., AUC = 0.9008;1.84 * Actinobacter Spp. – Akkermansia Muciniphila, AUC = 0.9008). AF paroxysm duration in CAD patients depends of plasma IL-6, TMAO, fecal Actinobacter Spp. and Akkermansia Muciniphila by the linear multifactorial regression analysis (AF paroxysm duration = 0.68*(Actinobacter Spp., lg/CFU/ml) – 3.33*(Akkermansia Muciniphila, lg/CFU/ml) – 0.6*IL6 – 0.34*TMAO – 0.98).

Conclusions: Gut microbiota condition is closely connected with occurrence AF of paroxysm in CAD patients. To find out the new ways of gut microbiota and CRF correction will be interesting in future investigations.


Hindricks, G, Potpara, T, Dagres, N, Arbelo, E, Bax JJ, Blomstrom-Lundqvist C, et all. (2020) ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal, 42,373498. doi:10.1093/eurheartj/ehaa612

Knuuti, J, Wijns, W, Saraste, A, Capodanno, D, Barbato, E, Funck-Brentano, C, et all. (2019) ESC Guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal, 41,407477. doi:10.1093/eurheartj/ehz425

Michniewicz, E., Mlodawska, E., Lopatowska, P., Tomaszuk-Kazberuk, A., & Malyszko, J. (2018). Patients with atrial fibrillation and coronary artery disease - Double trouble. Advances in medical sciences, 63(1), 30–35.

Agirman, G., Yu, K. B., & Hsiao, E. Y. (2021). Signaling inflammation across the gut-brain axis. Science (New York, N.Y.), 374(6571), 1087–1092.

Chen, W., Zhang, S., Wu, J., Ye, T., Wang, S., Wang, P., & Xing, D. (2020). Butyrate-producing bacteria and the gut-heart axis in atherosclerosis. Clinica chimica acta; international journal of clinical chemistry, 507, 236–241.

Lizogub, V.G., Kramarova, V.N., Melnychuk, I.O. (2019) The role of gut microbiota changes in the pathogenesis of heart disease. Zaporizkiy medical journal, 21, 5 (116), 672–678. doi: 10.14739 / 2310-1210.2019.5.179462

Chávez-Talavera, O., Tailleux, A., Lefebvre, P., & Staels, B. (2017). Bile Acid Control of Metabolism and Inflammation in Obesity, Type 2 Diabetes, Dyslipidemia, and Nonalcoholic Fatty Liver Disease. Gastroenterology, 152(7), 1679–1694.e3.

Takiishi, T., Fenero, C. I. M., & Câmara, N. O. S. (2017). Intestinal barrier and gut microbiota: Shaping our immune responses throughout life. Tissue barriers, 5(4), e1373208.

Li, J. J., Liu, H. H., & Li, S. (2022). Landscape of cardiometabolic risk factors in Chinese population: a narrative review. Cardiovascular diabetology, 21(1), 113.

Andrikoula, M., & McDowell, I. F. (2008). The contribution of ApoB and ApoA1 measurements to cardiovascular risk assessment. Diabetes, obesity & metabolism, 10(4), 271–278.

Kamstrup, P. R. (2021). Lipoprotein(a) and Cardiovascular Disease. Clinical chemistry, 67(1), 154–166.

Scheff, SW Fundamental Statistical Principles for the Neurobiologist. A Survival Guide. Lexington: Academic Press;2016.

Mandrekar J. N. (2010). Receiver operating characteristic curve in diagnostic test assessment. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 5(9), 1315–1316.

Chen, M., Fang, CY, Guo, JC, et all. (2023) Predictive value of atherogenic index of plasma and atherogenic index of plasma combined with low-density lipoprotein cholesterol for the risk of acute myocardial infarction Front Cardiovasc Med, 10, 1117362. doi: 10.3389/fcvm.2023.1117362. eCollection 2023.

Gawałko, M., Linz, D., & Dobrev, D. (2021). Gut-microbiota derived TMAO: A risk factor, a mediator or a bystander in the pathogenesis of atrial fibrillation? International journal of cardiology. Heart & vasculature, 34, 100818.

Dong, H., Wang, J., Hu, P., & Lu, N. (2023). Association of Apolipoprotein A1, High Density Lipoprotein Cholesterol, and Their Ratio with Inflammatory Marker in Chinese Adults with Coronary Artery Disease. Angiology, 74(8), 765–773.

Wang, J., Gu, X., Yang, J., Wei, Y., & Zhao, Y. (2019). Gut Microbiota Dysbiosis and Increased Plasma LPS and TMAO Levels in Patients With Preeclampsia. Frontiers in cellular and infection microbiology, 9, 409.

Gao, X., Du, L., Randell, E., Zhang, H., Li, K., & Li, D. (2021). Effect of different phosphatidylcholines on high fat diet-induced insulin resistance in mice. Food & function, 12(4), 1516–1528.

Zysset-Burri, D. C., Keller, I., Berger, L. E., Neyer, P. J., Steuer, C., Wolf, S., & Zinkernagel, M. S. (2019). Retinal artery occlusion is associated with compositional and functional shifts in the gut microbiome and altered trimethylamine-N-oxide levels. Scientific reports, 9(1), 15303.

Wieland, A., Frank, D. N., Harnke, B., & Bambha, K. (2015). Systematic review: microbial dysbiosis and nonalcoholic fatty liver disease. Alimentary pharmacology & therapeutics, 42(9), 1051–1063.

Ke, J., An, Y., Cao, B., Lang, J., Wu, N., & Zhao, D. (2020). Orlistat-Induced Gut Microbiota Modification in Obese Mice. Evidence-based complementary and alternative medicine: eCAM, 2020, 9818349.

Guo, G., Wu, Y., Liu, Y., Wang, Z., Xu, G., Wang, X., Liang, F., Lai, W., Xiao, X., Zhu, Q., & Zhong, S. (2023). Exploring the causal effects of the gut microbiome on serum lipid levels: A two-sample Mendelian randomization analysis. Frontiers in microbiology, 14, 1113334.

Lei, W., Cheng, Y., Gao, J., Liu, X., Shao, L., Kong, Q., Zheng, N., Ling, Z., & Hu, W. (2023). Akkermansia muciniphila in neuropsychiatric disorders: friend or foe? Frontiers in cellular and infection microbiology, 13, 1224155.

Luo, Y., Zhang, Y., Han, X., Yuan, Y., Zhou, Y., Gao, Y., Yu, H., Zhang, J., Shi, Y., Duan, Y., Zhao, X., Yan, S., Hao, H., Dai, C., Zhao, S., Shi, J., Li, W., Zhang, S., Xu, W., Fang, N., Li, Y. (2022). Akkermansia muciniphila prevents cold-related atrial fibrillation in rats by modulation of TMAO induced cardiac pyroptosis. EBioMedicine, 82, 104087.

Fang, C., Zuo, K., Zhang, W., Zhong, J., Li, J., Xu, L., & Yang, X. (2022). Association between Gut Microbiota Dysbiosis and the CHA2DS2-VASc Score in Atrial Fibrillation Patients. International journal of clinical practice, 7942605.

Xu, W., Yu, J., Yang, Y., Li, Z., Zhang, Y., Zhang, F., Wang, Q., Xie, Y., Zhao, B., & Wu, C. (2023). Strain-level screening of human gut microbes identifies Blautia producta as a new anti-hyperlipidemic probiotic. Gut microbes, 15(1), 2228045.

Costa, S. K., Antosca, K., Beekman, C. N., Peterson, R. L., Penumutchu, S., & Belenky, P. (2023). Short-Term Dietary Intervention with Whole Oats Protects from Antibiotic-Induced Dysbiosis. Microbiology spectrum, e0237623. Advance online publication.

McMillan, A. S., Foley, M. H., Perkins, C. E., & Theriot, C. M. (2023). Loss of Bacteroides thetaiotaomicron bile acid altering enzymes impact bacterial fitness and the global metabolic transcriptome. bioRxiv : the preprint server for biology, 2023.06.27.546749.

González-Morelo, K. J., Vega-Sagardía, M., & Garrido, D. (2020). Molecular Insights Into O-Linked Glycan Utilization by Gut Microbes. Frontiers in microbiology, 11, 591568.

Al-Kaisey, A. M., Figgett, W., Hawson, J., Mackay, F., Joseph, S. A., & Kalman, J. M. (2023). Gut Microbiota and Atrial Fibrillation: Pathogenesis, Mechanisms and Therapies. Arrhythmia & electrophysiology review, 12, e14.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.