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Scientists may have underestimated the role of the trillions of bacteria in our intestines in heart disease. People with clogged arteries have different gut microorganisms than people with healthy hearts, according to research published in AmSystems on November 6, 2025.
Coronary artery disease patients lack beneficial gut bacteria
Researchers at Sungkyunkwan University in South Korea examined gut bacteria samples from 28 healthy adults and 14 patients with coronary artery disease. They went deeper by examining the genes of these microbes and what those genes actually accomplish, rather than just counting the number of bacteria there.
People with coronary artery disease had very little good bacteria in their gut. Schlakia isoflavoniconconvertans and Faecalibacterium prausnitzii stood out in particular. Both create substances called short-chain fatty acids, which help control inflammation throughout the body.
Patients also had higher levels of bacteria belonging to the Lachnospiraceae family. Some of these bacteria are linked to a substance called TMAO, which has previously been linked to an increased risk of heart disease.
More amino acids, including arginine, were being broken down by bacteria in patients with coronary artery disease. This is important because nitric oxide, a chemical that maintains blood channel flexibility and relaxation, is partly produced by arginine. Blood vessels cannot function properly when there is insufficient arginine.
Gut bacteria ferment lactose and xylose
The patients’ gut bacteria demonstrated a high ability to ferment simple sugars such as lactose and xylose, which showed that their microbial communities had changed in response to different forms of food processing.
The team used computer models to predict the substances these bacteria would produce. Increased amounts of a particular molecule called inosine were observed in patients, although it is unknown how this molecule functions in relation to heart disease. Patients had lower levels of two additional chemicals than healthy controls.
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The study also showed that different strains of the same bacterial species can have very different effects, which could change our understanding of gut bacteria and health.
For example, Akkermansia muciniphila has genes that enable it to break down complex plant fibers in healthy individuals. These same genes were absent in patients with coronary artery disease.
Note to readers: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor with any questions you may have about a medical condition.
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