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Bacteria in the intestine affect the risk of heart attack
It has long been known that healthy intestinal flora makes an important contribution to protection against infections, allergies and other diseases. Researchers have now found that intestinal bacteria also have an impact on the risk of heart attack and stroke.
Number of deaths from heart disease has increased
Health experts say the number of deaths from heart disease has increased in recent years. In contrast, there was a decrease in mortality in acute heart attacks, the German Society for Cardiology - Cardiovascular Research e.V. reported earlier this year. Nevertheless, around 280,000 people in Germany still suffer a heart attack each year, and around 50,000 of them die from the consequences. Researchers have now been able to show that certain bacterial metabolites from the intestine increase the risk of suffering a heart attack or stroke.
Causes and risk factors for heart attack
Known causes of heart attack include high blood pressure, high blood cholesterol, smoking, obesity, lack of exercise and an increase in heart attacks in the family.
Patients who have already suffered a "cardiovascular event", that is to say a heart attack or a stroke, are also particularly at risk.
In two studies with a total of over 600 patients who had recently had a stroke, researchers from Germany and the United States have now investigated a risk factor that has hitherto been less known: the so-called microbiome, the bacteria in the intestine.
As reported by the Berlin Institute for Health Research / Berlin Institute of Health (BIH) in a communication, the investigation was conducted by BIH professor Ulf Landmesser with colleagues from the Department of Cardiovascular Medicine at Cleveland Clinic in Ohio and Professor Matthias Endres and colleagues from the Department of Neurology the Charité and carried out by the Hannover Medical School.
The results were published in the specialist magazine "Arteriosclerosis, Thrombosis, and Vascular Biology".
Connection between inflammation and arteriosclerosis
In their investigation, the researchers particularly measured the concentration of a metabolic product of the bacteria, trimethylamine oxide, and compared it with the risk of suffering a heart attack or stroke.
"We found that patients with a high trimethylamine oxide concentration in the blood were twice to five times as likely to have a heart attack or stroke as patients with a low concentration of the metabolite," said Ulf Landmesser, director of the clinic for cardiology at the Benjamin Franklin campus of the Charité and medical director of the CharitéCentrum for cardiovascular and vascular medicine at the Charité - Universitätsmedizin Berlin.
The trimethylamine oxide apparently stimulates the cells on the inner layer of the blood vessels, the endothelial cells, to form factors which promote blood clotting and inflammation of the vessels.
This in turn attracts inflammatory blood cells, monocytes, which in turn promote atherosclerosis and thrombosis in the blood vessel walls.
According to Landmesser, it was not a new idea at all: "The idea that inflammation is linked to arteriosclerosis goes back to Rudolf Virchow, who described it here in Berlin 160 years ago."
New ways of prevention
However, the knowledge that the microbiome and myocardial infarction or stroke are related also offers completely new ways of preventing these diseases.
To this end, the Berlin doctors have founded an international transatlantic research network of excellence with their colleagues from the United States to search for substances that can inhibit the formation of harmful metabolites in the bacteria.
"Conventional medications that inhibit blood clotting reduce the risk of heart attack, but at the same time increase the risk of bleeding," explained Landmesser.
“The interesting thing about this new approach is that by influencing the bacteria, you could reduce the risk of heart attack and stroke without increasing the risk of bleeding. So maybe a particularly elegant method of achieving the goal. "
Reduce myocardial infarction risk through food additives
Landmesser plans to test the knowledge gained in a clinical study on patients in the next three years.
But that's not all: "We have found other interesting metabolites in the microbiome that have a positive effect on cholesterol metabolism," said the expert.
"You could administer such a bacterial metabolite orally, as a food additive, and thus reduce the risk of heart attack."
So it would be completely wrong to demonize all the roommates in the gut, said Professor Ulf Landmesser.
“We have more bacteria in us than we have body cells. And these bacteria also do many things that are good for us. And of course we also want to research them and possibly use them in preventive approaches. ”(Ad)