The Role of Gut Microbiota on the metabolic and inflammatory biomarkers in Cardiovascular Surgery: A Systematic Review and Meta-Analysis

Context: 

The gastrointestinal microbiota is pivotal in cardiovascular surgery outcomes. This systematic review and meta-analysis aims to synthesize current evidence regarding the impact of gut microbiota on postoperative metabolomic markers and patient recovery.

Evidence Acquisition: 

Following PRISMA guidelines, a comprehensive search was conducted across MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL databases. Studies involving patients undergoing cardiovascular surgery and reporting on gut microbiota were included. Data extraction focused on study characteristics and metabolomic outcomes. The Newcastle-Ottawa Scale (NOS) assessed the risk of bias.

Six studies met the inclusion criteria, involving 530 patients. Meta-analysis revealed that a beneficial gut microbiota profile is associated with less increase in LDL cholesterol (Mean Difference: 14.4 mg/dL, SE: 0.816), a smaller decrease in HDL cholesterol (Mean Difference: -4.9 mg/dL, SE: 0.437), a lower rise in triglycerides (Mean Difference: 11.2 mg/dL, SE: 0.552), and a reduced elevation in CRP levels (Mean Difference: 2.4 mg/L, SE: 0.291) post-surgery. The overall risk of bias ranged from moderate to low across studies.

The findings suggest that gut microbiota composition significantly influences lipid metabolism and inflammatory responses post-cardiovascular surgery. A favorable microbiota profile may provide a protective effect against postoperative complications. These insights underline the potential for microbiota-modulating interventions in enhancing cardiovascular surgery outcomes.