The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.
Gut‐Derived Serum Lipopolysaccharide is Associated With Enhanced Risk of Major Adverse Cardiovascular Events in Atrial Fibrillation: Effect of Adherence to Mediterranean Diet
Open accessAbstract
Background Gut microbiota is emerging as a novel risk factor for atherothrombosis, but the predictive role of gut‐derived lipopolysaccharide ( LPS ) is unknown. We analyzed (1) the association between LPS and major adverse cardiovascular events ( MACE ) in atrial fibrillation ( AF ) and (2) its relationship with adherence to a Mediterranean diet (Med‐diet). Methods and Results This was a prospective single‐center study including 912 AF patients treated with vitamin K antagonists (3716 patient‐years). The primary end point was a composite of MACE . Baseline serum LPS , adherence to Med‐diet (n=704), and urinary excretion of 11‐dehydro‐thromboxane B 2 (TxB 2 , n=852) were investigated. Mean age was 73.5 years; 42.9% were women. A total of 187 MACE (5.0% per year) occurred: 54, 59, and 74 in the first, second, and third tertile of LPS , respectively (log‐rank test P =0.004). Log‐ LPS (hazard ratio 1.194, P =0.009), age (hazard ratio 1.083, P <0.001), and previous cerebrovascular (hazard ratio 1.634, P =0.004) and cardiac events (hazard ratio 1.822, P <0.001) were predictors of MACE . In the whole cohort, AF (versus sinus rhythm) (β 0.087, P =0.014) and low‐density lipoprotein cholesterol (β 0.069, P =0.049) were associated with circulating LPS . Furthermore, Med‐diet score (β −0.137, P <0.001) was predictive of log‐ LPS , with fruits (β −0.083, P =0.030) and legumes (β −0.120, P =0.002) negatively associated with log‐ LPS levels. Log‐ LPS and log‐TxB 2 were highly correlated (r=0.598, P <0.001). Log‐ LPS (β 0.574, P <0.001) and Med‐diet score (β −0.218, P <0.001) were significantly associated with baseline urinary excretion of TxB 2 . Conclusions In this cohort of AF patients, LPS levels were predictive of MACE and negatively affected by high adherence to Med‐diet. LPS may contribute to MACE incidence in AF by increasing platelet activation.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Figures
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“In a recent observational study, circulating LPS concentrations were predictive of MACE in a cohort of patients with atrial fibrillation, suggesting that endotoxin translocation impacts CVD complications27.”
From Gut microbiota and cardiovascular disease. (2020) · cites this paper as [27]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,739
Cook, R. J., Dickens, B. M., & Fathalla, M. F. (2003) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199241323.003.0025 · Cited by 10,825
ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012
Authors/Task Force Members, McMurray, J. J. V., Adamopoulos, S., Anker, S. D., Auricchio, A., Böhm, M., Dickstein, K., Falk, V., Filippatos, G., Fonseca, C., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs104 · Cited by 6,879
Guidelines for the management of atrial fibrillation
Authors/Task Force Members, Camm, A. J., Kirchhof, P. F., Lip, G. Y. H., Schotten, U., Savelieva, I., Ernst, S., Gelder, I. C. V., Al‐Attar, N., Hindricks, G., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq278 · Cited by 5,954
Universal Definition of Myocardial Infarction
Thygesen, K. A., Alpert, J. S., White, H. D., TASK FORCE MEMBERS: Chairpersons: Kristian Thygesen (Denmark), J. S. A. (., Biomarker Group: Allan S. Jaffe, C. (., ECG Group: Bernard Chaitman, C.-O. (., Imaging Group: Richard Underwood, C. (., Intervention Group: Jean-Pierre Bassand, C.-O. (., Mendis, S., Implementation Group: Lars C. Wallentin Coordinator (Sweden), F. F.-A. (., et al. (2007) · Circulation · doi:10.1161/circulationaha.107.187397 · Cited by 4,422
(2001) · Journal of obstetrics and gynaecology research · doi:10.1111/j.1447-0756.2001.tb01222.x · Cited by 3,515
Christiane, Druml, Wolzt, & Pleiner (2001) · Acta Scientiarum Naturalium Universitatis Sunyatseni · Cited by 3,419
Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk
Tang, W. H. W., Wang, Z., Levison, B. S., Koeth, R. A., Britt, E. B., Fu, X., Wu, Y., & Hazen, S. L. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1109400 · Cited by 3,400
ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012
Authors/Task Force Members, McMurray, J. J. V., Adamopoulos, S., Anker, S. D., Auricchio, A., Böhm, M., Dickstein, K., Falk, V., Filippatos, G., Fonseca, C., et al. (2012) · European Journal of Heart Failure · doi:10.1093/eurjhf/hfs105 · Cited by 2,644
Task Force Members, Thygesen, K. A., Alpert, J. S., White, H. D., Biomarker Group, Jaffe, A. S., Apple, F. S., Galvani, M., Katus, H. A., Newby, L. K., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm355 · Cited by 2,536
Cited by
Sorted by citations
The gut microbiota at the intersection of diet and human health
Gentile, C. L., & Weir, T. L. (2018) · Science · doi:10.1126/science.aau5812 · Cited by 1,049
Gut microbiota and cardiovascular disease.
Witkowski, M., Weeks, T. L., & Hazen, S. L. (2020) · Circulation Research · doi:10.1161/circresaha.120.316242 · Cited by 1,051
Atrial Fibrillation: Pathogenesis, Predisposing Factors, and Genetics
Sagris, Μ., Vardas, E. P., Theofilis, P., Antonopoulos, A. S., Oikonomou, E. K., & Tousoulis, D. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms23010006 · Cited by 408
Beyond gut feelings: how the gut microbiota regulates blood pressure
Marques, F. Z., Mackay, C. R., & Kaye, D. M. (2017) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2017.120 · Cited by 408
Mediterranean diet and health status: Active ingredients and pharmacological mechanisms
Schwingshackl, L., Morze, J., & Hoffmann, G. (2020) · British Journal of Pharmacology · doi:10.1111/bph.14778 · Cited by 336
Metadata
- Authors
- Pastori, D., Carnevale, R., Nocella, C., Novo, M., Santulli, M., Cammisotto, V., Menichelli, D., Pignatelli, P., & Violi, F.
- Affiliations
- Sapienza University of Rome (IT)
- Corresponding author
- Violi, Francesco
- ORCID
- Venue
- Journal of the American Heart Association
- Published
- 2017-11-06
- Volume
- 6
- Issue
- 6
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC5669181
- OpenAlex
- W2623414143
- Cited by
- 182
- References
- 45
- Citations by year
- 2026: 22 · 2025: 18 · 2024: 30 · 2023: 28 · 2022: 27 · 2021: 24 · 2020: 12 · 2019: 11 · 2018: 7 · 2017: 3
- FWCI
- 6.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- atrial fibrillation, major adverse cardiovascular events, Mediterranean diet adherence, gut microbiota, atherothrombosis, 11-dehydrothromboxane B2, vitamin K antagonists, Fabaceae, fruits, LDL cholesterol, cerebrovascular events, cardiac events, serum biomarkers, risk prediction, vitamin B12 deficiency, folate deficiency, vitamin K deficiency, scurvy, vitamin E deficiency, vitamin A deficiency
- MeSH terms
- Gastrointestinal Microbiome, Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Bacteria, Cerebrovascular Disorders, Female, Humans, Intestines, Lipopolysaccharides, Male, Patient Compliance, Prospective Studies, Risk Factors, Rome, Time Factors, Vitamin K, Biomarkers, Platelet Activation, Treatment Outcome, Myocardial Ischemia, Diet, Mediterranean, Kaplan-Meier Estimate, Protective Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
