Probiotics and Prebiotics in Post-Myocardial Infarction Rehabilitation: Mechanisms, Benefits, and Future Directions

Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide, and rehabilitation is essential to improve patient outcomes and reduce the risk of recurrent cardiovascular events. This review aims to summarize research on the gut-heart axis and the therapeutic potential of probiotics and prebiotics in MI rehabilitation, highlighting their ability to modulate gut microbiota composition and activity to benefit cardiovascular health.

Recent studies have identified the gut microbiome as a critical modulator of myocardial health, with dysbiosis-an imbalance in microbial populations-associated with increased production of proinflammatory metabolites such as trimethylamine-N-oxide (TMAO), which exacerbate endothelial dysfunction and thrombosis in MI patients. Studies show that probiotic strains and prebiotics can improve blood lipid profiles, regulate blood pressure, inhibit the progression of endothelial dysfunction, promote the growth of beneficial bacteria, and increase cardioprotective short-chain fatty acids. The use of probiotics and prebiotics in MI patients may be of advantage in cardiac rehabilitation. Probiotics and prebiotics have been shown to offer potential benefits in mitigating inflammation, improving endothelial function, and optimizing metabolic health. These microbiome-targeted strategies may complement existing rehabilitation approaches, potentially reducing the risk of recurrent cardiovascular events and improving long-term outcomes for patients with MI. However, further research is necessary to elucidate the underlying mechanisms and substantiate the clinical efficacy of these therapeutic interventions.