Gut microbiota modulation by postbiotics in patients with coronary artery disease and atrial fibrillation

Abstract

The aim: is to improve gut microbiota composition by the long-term postbiotics (glycine and propionic acid) supplementation in patients with coronary artery disease (CAD) and atrial fibrillation (AF). Materials and methods: 40 patients were divided into 3 groups: first (CAD) – 14 patients with CAD but without arrhythmias; second (CAD+AF) – 18 patients with CAD and AF paroxysm; and the control group – 8 patients without CAD and arrhythmias. 16 patients from the II group received basic therapy, according to the latest ESC guidelines, and postbiotic supplementation: rebamipide (2-(4-chlorobenzoylamino)-3-[2(1H))-quinolon-4-yl] propionic acid) by 100 mg 3 times a day and glycine by 100 mg 3 times a day during 6 months. 16-S rRNA sequencing checked gut microbiota composition. Results: The II group patients had a significant rise in Pseudomonadota (by taxonomic analysis), Actinobacter Spp. and a decrease in Blautia Spp., Bacteroides Thetaiotaomicron compared with the I group, P<0.05. Long-term postbiotics supplementation for patients with coronary artery disease and atrial fibrillation leads to a significant decrease in Firmicutes/ Bacteroides ratio, P<0.05; a significant rise in Verrucomicrobiota and a decrease in Firmicutes, P<0.05; a significant increase in Lactobacillus spp., Akkermansia muciniphila, Blautia spp., Prevotella spp. and a decrease in Streptococcus spp. and Methanosphaera stadmanae, P<0.05. A significantly lower F/B ratio was found in the patients with long-term postbiotics supplementation in comparison with placebo group patients, P<0.05. A significant increase in Actinomycetota was found in the patients with long-term postbiotics supplementation compared to placebo group patients, P<0.05. A significant increase in probiotic species (Akkermansia muciniphila, Blautia spp., Eubacterium Rectale, and Prevotella spp.) and a decrease in species, associated with cardiometabolic disorders (Streptococcus spp.) was found in the patients with long term postbiotics supplementation in comparison with placebo group patients, P<0.05. Conclusion: Long-term postbiotics supplementation for patients with coronary artery disease and atrial fibrillation leads to positive gut microbiota modulation