Effect of evolocumab on the gut microbiota in patients with acute myocardial infarction.

No significant alpha-diversity differences were observed among the AMI baseline, AMI post-treatment, and healthy control groups.

• P > 0.05 for all alpha-diversity comparisons among groups
• Study included 26 AMI patients and 18 age-matched healthy volunteers
• 16S rRNA sequencing was performed on samples from all groups
• Sequencing data deposited at NCBI SRA: PRJNA1154993

Firmicutes was the dominant phylum at AMI baseline but decreased following evolocumab treatment and was lower in healthy controls.

• Firmicutes abundance: AMI baseline (0 W) 76.32%, post-treatment (8 W) 65.22%, healthy controls 60.40%
• The trend shows a movement toward the healthy control profile following 8 weeks of evolocumab treatment
• Evolocumab was administered at 420 mg every 4 weeks alongside standard therapy

Bacteroidota abundance increased following evolocumab treatment, moving closer to levels observed in healthy controls.

• Bacteroidota abundance: AMI baseline (0 W) 15.07%, post-treatment (8 W) 19.99%, healthy controls 27.11%
• Post-treatment Bacteroidota levels remained below healthy control levels despite the increase
• Proteobacteria and Actinobacteria were the second most abundant phyla observed across groups

Significant differences in the abundances of nine types of bacteria at the genus level were identified among the three groups.

• Genus-level difference analysis revealed significant differences among AMI baseline, AMI post-treatment, and healthy control groups
• Abundances of beneficial bacteria Odoribacter and Parabacteroides were increased in the AMI-evolocumab (8 W) group compared with the AMI-evolocumab (0 W) group
• The study design was prospective with patients receiving statins for at least 8 weeks prior to evolocumab administration

The study was designed as a prospective investigation of 26 AMI patients treated with evolocumab added to standard therapy including statins.

• Patients were required to be on statins for at least 8 weeks before study enrollment
• Evolocumab was administered at a dose of 420 mg every 4 weeks
• 18 age-matched healthy volunteers served as controls
• Gut microbiota was analyzed using 16S rRNA sequencing at baseline (0 W) and after 8 weeks of treatment (8 W)