Effect of coexistence of Chlamydia pneumoniae and increased epicardial fat thickness on coronary artery disease.

OBJECTIVE: Epicardial fat thickness (EFT) and chlamydia infection are independent cardiovascular risk factors in coronary artery disease (CAD). We aimed to evaluate the effect of coexistence of EFT and chlamydia infection on the presence and severity of CAD in patients with stable angina pectoris (SAP). PATIENTS AND METHODS: The study included 208 patients with SAP, divided into a CAD group (n=112) and a control group (n=96). The presence of Chlamydia pneumoniae-IgG (CP-IgG), EFT, and left ventricular ejection fraction (LVEF) were compared between groups. RESULTS: CP-IgG, LVEF, and EFT were found to be independent predictors of CAD (CP-IgG, OR=1.559, p=0.021; LVEF, OR=0.798, p<0.001; EFT, OR=3.175, p=0.026). Moreover, a statistically significant interaction was detected between CP-IgG and EFT for predicting the presence of CAD (p<0.001). A good positive correlation was found between EFT and Gensini score (r=0.684, p<0.001). CONCLUSIONS: We found that there was an interaction between CP-Ig and EFT for CAD development. This finding suggests that the interaction of CP-IgG and EFT plays a prominent role in the inflammatory process.

Effect of DLT-SML on Chronic Stable Angina Through Ameliorating Inflammation, Correcting Dyslipidemia, and Regulating Gut Microbiota.

ABSTRACT: Chronic stable angina (CSA) is caused by coronary atherosclerosis. The gut microbiota (GM) and their metabolite trimethylamine-N-oxide (TMAO) levels are associated with atherosclerosis. Danlou tablet (DLT) combined with Salvia miltiorrhiza ligustrazine (SML) injection has been used to treat CSA. This study aims to investigate how DLT combined with SML (DLT-SML) regulates serum lipids, inflammatory cytokines, GM community, and microbial metabolite in patients with CSA. In this study, 30 patients with CSA were enrolled in the DLT-SML group, and 10 healthy volunteers were included in the healthy control group. The patients in the DLT-SML group were subdivided as the normal total cholesterol (TC) group and high-TC group according to their serum TC level before treatment. Blood samples were collected to investigate the (1) lipid content, including triglyceride (TG), TC, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, (2) fasting blood glucose (Glu), (3) inflammatory cytokines, including interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α), and (4) gut-derived metabolite, including lipopolysaccharides and TMAO level. GM composition was analyzed by sequencing 16S rRNA of fecal samples. Results showed that DLT-SML significantly decreased serum TG, TC, low-density lipoprotein cholesterol, IL-1ß, TNF-α, and TMAO levels of patients with CSA. DLT-SML increased the abundance of Firmicutes and decreased Proteobacteria, which were significantly lower or higher in patients with CSA, respectively, compared with the healthy control group. In particular, DLT-SML increased the microbial diversity and decreased Firmicutes/Bacteroidetes ratio of patients with high-TC. The abundance of Sarcina, Anaerostipes, Streptococcus, Weissella, and Erysipelatoclostridium was decreased, whereas Romboutsia, Faecalibacterium, and Subdoligranulum were increased by DLT-SML treatment in patients with CSA. These findings indicated that DLT-SML improved patients with CSA by ameliorating dyslipidemia profile, decreasing the circulating inflammatory cytokines, and regulating the GM composition and their metabolites.