Abstract
Background
Acute myocardial infarction (AMI) remains a major cause of global mortality, with post-infarction cardiovascular events significantly contributing to poor outcomes. Emerging evidence suggests that gut microbiome dysbiosis may influence cardiovascular risk through increased intestinal permeability and systemic inflammation. Although lactulose—a prebiotic known to modulate gut microbiota—has shown beneficial effects in experimental models, its impact on major adverse cardiovascular events (MACEs) after AMI remains unclear.
Methods
In this single-center retrospective cohort study, we analyzed 165 AMI patients hospitalized between 2016 and 2019. Participants were stratified by lactulose use during hospitalization. The primary outcome was in-hospital MACEs. Multivariable logistic regression was used. Secondary outcomes included pneumonia incidence and length of hospital stay.
Results
After adjustment for confounders, lactulose use was independently associated with a reduced risk of MACEs (adjusted odds ratio (OR) 0.40, 95% confidence interval (CI) 0.16–0.95; p = 0.038). The overall incidence of MACEs was 18.2% in the lactulose group versus 30.0% in controls, though this difference was not statistically significant in unadjusted analysis (χ² = 2.41, p = 0.12), likely reflecting limited statistical power. No significant associations were observed for pneumonia (OR = 0.17, p = 0.09) or hospital stay duration (p = 0.60).
Conclusions
In this retrospective analysis, lactulose supplementation was associated with reduced in-hospital cardiovascular events following AMI. However, these preliminary findings require validation in larger prospective studies to establish causality and elucidate underlying gut-mediated mechanisms. If confirmed, lactulose may represent a simple and accessible adjunct therapy in post-infarction care.
Keywords
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Supplementary Material
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