Researchers are finding on a regular basis a connection between the bacterial composition in one’s gut and various diseases and conditions. Now, a groundbreaking study at the cardiology department of the Rabin Medical Center-Beilinson Campus in Petah Tikva and the Weizmann Institute of Science in Rehovot has identified a link between the composition of bacteria in the gastroenterological system and heart attacks. 

Dr. Yeela Talmor-Barkan from Beilinson and the director of the cardiology department, Prof. Ran Kornowski, in collaboration with Prof. Eran Segal and the doctoral student Noam Bar from Weizmann’s department of computer science and applied collected detailed clinical data and biological samples from 1,169 participants. Using the information gathered, the researchers created a large-scale database that was also measured and tested by the European research group MetaCardis. 

They published their findings in the prestigious journal Nature Medicine under the title “Metabolomic and microbiome profiling reveals personalized risk factors for coronary artery disease.” 

“Our study showed that the composition of bacteria in the gut differs significantly between healthy people and patients with coronary artery disease [CAD],” said Talmor-Barkan. “Complex diseases such as are often multifactorial, caused by multiple underlying pathological mechanisms,” they wrote. “Here, to study the multifactorial nature of CAD, we performed comprehensive clinical and multi-omic profiling [analysis of large amounts of data representing an entire set of some kind, especially the entire set of molecules, such as proteins, lipids or metabolite, in a cell, organ or organism.” 

They studied gut microbiome data in 199 patients just a few hours after they suffered a heart attack (acute coronary syndrome or ACS) recruited from two major Israeli hospitals and validated these results in a geographically distinct group. They studied the bacteria balance in the patients’ guts and compared them to those of a control group. The team found that ACS patients had distinct serum metabolome and gut microbial signatures, compared with control individuals and had a lack of a previously unknown bacterial species of the Clostridiaceae family. 

This bacterial species was connected with levels of multiple circulating metabolites in control individuals, several of which have previously been linked to an increased risk of CAD. In addition, metabolic problems in ACS patients linked to microbiome and diet were also seen to a lesser extent in control individuals with metabolic impairment.  

The findings thus suggest that the bacterial composition in the gut of heart patients is significantly different from that of healthy people. The breakdown products of the bacteria are absorbed from the intestine into the bloodstream and thus actually affect the blood vessels and heart.

This is the largest and most in-depth study conducted to date in the field of microbiome in heart patients, with the aim of finding new risk factors for heart attacks, given the high recurrence rates of the disease despite optimal treatments for known risk factors.

Talmor-Barkan, who initiated the research added: “The study emphasizes the importance of personalized medicine in the field of cardiology. For each study participant, we mapped thousands of blood molecules (metabolites) associated with gut bacteria and known cardiovascular risk factors, such as genetics, diet, high cholesterol, diabetes and hypertension. Using these data, we built a personal metabolic map for each heart patient, which makes it possible to assess the risk factors that are not optimally balanced in him and may have led to the recurrence of the disease.” 

“This is a significant discovery in cardiology,” commented Kornowski. “The results of the study form the basis for developing new diagnostic and treatment tools for cardiovascular disease, such as developing individual bacterial capsules and/or treating metabolic factors with more precise and customized molecular methods.” 

Segal said that “beyond discoveries in the cardiovascular field, as part of the study we developed a new method for personalized medicine that can be used to identify the causes of heart disease by comparing a single patient to a control group of healthy people with similar characteristics.” 

Bar at Weizmann pointed out that “in the study, we used advanced molecular and computational methods that allowed us for the first time to map and explain the differences between heart patients at the metabolic level. Among other things, we found differences in blood composition in patients with the same clinical profile and genetics that can guide us in tailoring treatment to the individual level.