Study Links Gut Microbes to Coronary Artery Disease Risk

A recent study from researchers in Seoul indicates that gut microbes may significantly influence the development of coronary artery disease (CAD), a leading cause of death globally, responsible for nearly 20 million fatalities each year from cardiovascular diseases. While genetic and environmental factors are known to affect an individual’s risk, the role of gut microbiota is gaining attention as a potential contributor to disease progression.

In the journal mSystems, the team led by Han-Na Kim, Ph.D., a genomicist at the Samsung Advanced Institute for Health Sciences and Technology at Sungkyunkwan University, reported on their findings regarding the connection between gut microbes and CAD. “We’ve gone beyond identifying ‘which bacteria live there’ to uncovering what they actually do in the heart-gut connection,” Kim explained.

The researchers analyzed fecal samples from 14 individuals diagnosed with CAD and 28 healthy individuals. They employed metagenomic sequencing, a method that decodes the DNA present in a sample, allowing for the reconstruction of individual microbial genomes. This approach enabled the identification of 15 bacterial species associated with CAD and highlighted pathways linking gut microbes to the disease’s progression.

Kim noted that their metagenomic analysis revealed significant shifts towards inflammation and metabolic imbalance in individuals with CAD. Specifically, there was a loss of beneficial short-chain fatty acid producers, such as Faecalibacterium prausnitzii, and an overactivation of pathways, including the urea cycle, which are linked to increased disease severity.

Intriguingly, this research also suggested that strains of bacteria traditionally viewed as beneficial can exhibit harmful effects depending on their context. For instance, microbes like Akkermansia muciniphila and F. prausnitzii can perform different functions in healthy versus diseased guts.

The study’s complexity is underscored by previous findings that reported reduced levels of certain Lachnospiraceae species in CAD patients. In contrast, this research found higher levels of other types within the same family. “Lachnospiraceae may be the Dr. Jekyll and Mr. Hyde of the gut,” Kim remarked, noting that some species are diminished in CAD patients while others are increased.

The next phase of this research aims to integrate microbial signals with genetic and metabolomic data to establish precise causal pathways in heart disease. Kim emphasized that this work could lead to the development of precision-based interventions that translate microbial insights into effective prevention strategies for cardiovascular diseases.

According to Kim, prevention represents a critical frontier in combating the global burden of heart disease. Potential microbial therapies could play a role in this effort, such as enhancing stool-based screening methods or implementing nutritional interventions designed to restore beneficial bacteria and inhibit harmful pathways.

For further reading, the full study is published in mSystems (2025) and can be accessed at journals.asm.org/doi/10.1128/msystems.00954-25.