AUTHOR=Issilbayeva Argul , Sergazy Shynggys , Zhashkeyev Azamat , Gulyayev Alexandr , Kozhakhmetov Samat , Shulgau Zarina , Nurgaziyev Madiyar , Nurgaziyeva Ayaulym , Zhetkenev Sanzhar , Mukhanbetzhanov Nurislam , Jarmukhanov Zharkyn , Mukhanbetzhanova Zhanel , Vinogradova Elizaveta , Zhumadilov Zhaxybay , Kushugulova Almagul , Aljofan Mohamad 

TITLE=Polyphenol-mediated microbiome modulation in STEMI patients: a pilot study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1522373

DOI=10.3389/fmed.2025.1522373

ISSN=2296-858X

ABSTRACT=IntroductionThis study investigates the effects of polyphenol supplementation on gut microbiome composition and cardiovascular health in patients with ST-segment elevation myocardial infarction (STEMI).MethodsDouble-blind randomized control trial where participants received either polyphenol supplementation or placebo for 3 months, after which composition of the gut microbiome; clinical and laboratory parameters, including TMAO levels and oxidative stress levels, were assessed.ResultsThe stable TMAO levels (from 0.5 [0.2–0.9] to 0.4 [0.3–0.9] μmol, p > 0.05) were observed in the polyphenol group, compared to the increase observed in the placebo group (from 0.5 [0.3–0.6] to 0.7 [0.5–1.4] μmol, p < 0.001). Polyphenol supplementation significantly decreased the Firmicutes/Bacteroidetes ratio (p = 0.04) and increased beneficial bacteria such as Roseburia (p = 0.01), Agathobaculum sp. (p = 0.004), Alistipes finegoldii (p = 0.04) and Sellimonas (p = 0.002). Predicted metabolic pathways analysis supports potential mechanisms linking polyphenol intake to microbiome modulation and TMAO regulation.ConclusionOur findings demonstrate that polyphenol supplementation maintains stable TMAO levels by restructuring gut microbiome composition in STEMI patients, evidenced by a more focused microbiome with a significant increase in beneficial butyrate-producing bacteria (Roseburia, Agathobaculum sp., Alistipes finegoldii, and Sellimonas) and a decreased Firmicutes/Bacteroidetes ratio, suggesting microbiome-mediated cardioprotective effects. While promising,l our preliminary findings require further studies with larger cohorts and more advanced sequencing methods to establish their significance for cardiovascular health.Clinical trial registrationClinicalTrial.gov, identfier: NCT06573892.