Bacteria may be responsible for heart attacks

UNITED STATES, WASHINGTON (OBSERVATORY) — Microorganisms living in the human body can trigger processes leading to a heart attack. In particular, destabilization of plaques in the coronary arteries can be the cause of a heart attack.

The discovery at the Congress of the European Society of Cardiology ( the ESC Congress 2019 ) reported a team of scientists led by Eugenio Pisano ( Eugenia Pisano ) of the Catholic University of the Sacred Heart in Italy.

It has long been known that diet, smoking, environmental pollution, age and the use of certain drugs have a great influence on the physiology of cells, the immune system and metabolism. Heart attacks and heart disease in general are also associated with all of these factors.

But intestinal bacteria play an important role in many processes of our body, including the development of cardiovascular diseases. Therefore, in their new work, the specialists decided to examine in more detail the existing relationships.

The study involved 30 patients with acute coronary syndrome (having suffered a heart attack) and 10 patients with stable angina pectoris.

Participants from both groups had plaques in the coronary arteries. They are accumulations of platelets and inflammatory cells. When these clusters become unstable and move from the place of formation, they clog the arteries, leading to coronary heart disease, angina pectoris, and heart attacks.

The authors studied intestinal bacteria isolated from volunteer stool samples, as well as bacteria obtained from coronary artery plaques using angioplasty (procedure for opening the affected artery using a thin catheter with an expandable balloon at the end).

Comparison of intestinal microbiota and coronary plaques showed interesting results. The composition of bacteria from the first samples was very diverse, and bacteria of the Bacteroidetes and Firmicutes types prevailed in it.

Meanwhile, coronary plaques mainly contained bacteria belonging to the types Proteobacteria and Actinobacteria, which cause inflammatory reactions (pro-inflammatory bacteria).

“This suggests selective retention of pro-inflammatory bacteria in atherosclerotic plaques , which can provoke an inflammatory response and rupture of the plaque,” explains Eugenia Pisano.

The analysis also revealed differences in intestinal microbiota between the two groups of participants. Thus, patients with acute coronary syndrome had more representatives of the Firmicutes, Fusobacteria and Actinobacteria types , while bacteria of the Bacteroidetes and Proteobacteria types were more common among patients with stable angina pectoris.

“Various chemicals released by these bacteria can affect the destabilization of [coronary] plaques and subsequent heart attack,” Pisano explains.

According to her, so far there has been no convincing evidence that infections and subsequent inflammation are directly involved in the process of destabilization of coronary plaques and the occurrence of a heart attack. However, the results of the new work indicate the existence of certain infectious triggers that may play a role in these processes.

“The microbiota in the gut and coronary plaque can play a pathogenetic role in destabilizing the plaque and may become a potential therapeutic target. Further studies will show us whether antibiotics can prevent the cardiovascular effects in some patients,” concludes Pisano.


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