LAUSR

1. Studies have found that gut microbiota is a new participant and potential therapeutic target for CVD and even MI. 2. No clinical study to date, however, has investigated whether the changes of gut microbiota associated with coronary lesion degree and prognosis in patients with acute coronary syndrome (ACS). We prospectively investigated associations, of gut microbiota in their feces and coronary lesion degree, and long-term prognosis of patients with ACS. 1. In prospective cohort study, a total 502 subjects including 402 ACS patients and 100 controls. Fecal specimens were used to extract bacterial genomic DNA 2. 16S rDNA sequence of bacteria were generated to analyse specific gut microbial taxa associated with ACS onset for 60 ACS patients and 30 healthy controls. 3. Specific primers were designed according to the 16S rDNA sequence of bacteria for real time PCR reaction to determine the number of different bacteria. 4. All ACS patients calculated SYNTAX score by coronary radiography results and followed up for one year. The correlation of gut microbiota with coronary angiographic severity and prognosis in the ACS patients was analyzed. 1. Compared with the control group,the number of bacteria in Escherichia coli, Streptococcus and Enterobacteriaceae increased significantly (P<0.05) and Lactobacillus decreased significantly (P<0.05) in patients with ACS. 2. Lactobacillus were independent predictors of coronary angiographic severity in patients with ACS (HR=0.953; 95% CI: 0.935–0.970, P<0.001). 3. Decreased Lactobacillus levels were independent protection factors with all-cause death (HR=0.954; 95% CI: 0.913–0.997, P=0.038) and risk of major adverse cardiac events (HR=0.952; 95% CI: 0.929–0.976, P<0.001),especially for heart failure in long-term prognosis(HR=0.960; 95% CI: 0.932–0.989, P=0.007). 1. Number of Lactobacillus are significantly decreased in patients with ACS,and associated with SYNTAX score,suggesting that Lactobacillus is associated with severity of coronary artery disease, all-cause death and MACE. 2. It provides new ideas for the prevention and treatment of ACS. Real time PCR Type of funding source: Public Institution(s). Main funding source(s): Major Science and Technology Projects of Tianjin Science and Technology Commission in 2016