Comparisons of microbiota-generated metabolites in patients with young and elderly acute coronary syndrome.

OBJECTIVE: Acute coronary syndrome (ACS) is a leading cause of death worldwide. There is great interest in defining the risk factors and underlying mechanisms of ACS among young people. The microbiota and its metabolites have recently become a popular research topic, yet there is still no study that investigated microbiota-generated metabolites as a possible risk factor in young patients with ACS. In this study, we aimed to investigate the relationship between microbiota-generated metabolites and ACS in young people. METHODS: This study included 44 young patients with ACS (<50 years of age), 39 elderly patients with ACS, and 44 patients with normal coronary arteries. Inflammatory parameters and serum trimethylamine N-oxide (TMAO) and choline levels were measured in all patients. RESULTS: Young patients with ACS had significantly higher levels of TMAO and choline compared to the control and elderly ACS groups. Also, elderly patients with ACS had a significantly higher level of TMAO than the control group. Linear regression analysis was performed to determine the independent predictors of TMAO. Two regression models were involved. The first model included young ACS and control groups, while the second model included young and elderly ACS groups. In the first model, we found that young ACS (ß=0.399, p=0.004) and smoking ACS (ß=0.211, p=0.046) were significantly associated with TMAO level. In the second model, young ACS was significantly associated with TMAO level (ß=0.230, p=0.035). CONCLUSION: In this study, we have shown that young ACS was significantly associated with increased TMAO level.

An investigation of the relationship between arterial aortic stiffness and coronary slow flow that was detected during coronary angiography.

AIM: Increased intimal thickness in coronary arteries, extensive calcification, and atheromatous plaque that does not cause luminal irregularities in a significant portion of the patients with coronary slow flow (CSF). Arterial stiffness is an indicator for atherosclerosis. We aimed to investigate the relation between coronary slow flow phenomenon (CSFP) and arterial stiffness. METHOD: Total of 73 patients were included in the study, and a control group was formed with 64 individuals. Aortic stiffness index ß (ASIß) and pulse wave velocity (PWV) were used as the determinant of arterial stiffness in all analyses. RESULT: Pulse wave velocity values were significantly higher in the coronary slow flow group than the control group (P < .001). PWV, aortic stiffness index ß (ASIß) values were found to be significantly higher in the CSF group. ASIß value was 3.4 ± 1.0 in CSF patients and 2.2 ± 0.6 in the control group (P < .001). Receiver operating characteristic curve (ROC) analysis showed that PWV predicted coronary slow flow with 97% sensitivity and 90% specificity for 7.15 cutoff value. And aortic stiffness index was found to predict coronary slow flow with 83% sensitivity and 75% specificity for 2.63 cutoff value. CONCLUSION: Our findings prove that coronary slow flow phenomenon should be considered a subgroup of coronary artery diseases and that increased PWV is an indicator of CSFP.