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Effects of Gut Microbiota-Modulating Interventions on Systemic Inflammation and Functional Outcomes in Established

Ishtiaq Ahmad1, Manoj Sivakumar2, Shivam Singla3

  • 1Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, USA.

Cureus
|June 1, 2026
PubMed

Insights

Gut microbiota interventions show potential for reducing inflammation in cardiovascular disease patients. However, consistent improvements in heart function or clinical outcomes require further investigation in larger trials.

Area of Science:

  • Cardiology
  • Microbiology
  • Gastroenterology

Background:

  • Cardiovascular disease (CVD) is a major global health concern with persistent inflammation.
  • The gut-heart axis, involving gut dysbiosis and inflammation, is increasingly linked to CVD pathogenesis.
  • Current treatments do not fully address residual inflammatory risk in CVD.

Purpose of the Study:

  • To systematically review the effects of gut microbiota-modulating interventions on inflammation and clinical outcomes in adults with established CVD.
  • To assess the impact of probiotics, postbiotics, and microbiota-targeted antibiotics on systemic inflammation.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) from January 2020 to December 2024.
  • Searched databases: PubMed/MEDLINE, Scopus, Web of Science.
  • Included adults with coronary artery disease, heart failure, or cerebrovascular accident.

Main Results:

  • Four RCTs met inclusion criteria.
  • Microbiota interventions significantly reduced inflammatory markers (e.g., IL-1β, hs-CRP, LPS).
  • Functional capacity improved in one heart failure trial; others showed no significant cardiac benefits.

Conclusions:

  • Gut microbiota modulation may offer anti-inflammatory benefits in established CVD.
  • Consistent functional or structural cardiac improvements are not yet demonstrated.
  • Larger trials with standardized endpoints are needed for secondary cardiovascular prevention.

Keywords:
cardiovascular diseasecoronary artery diseasegut microbiotaheart failureinflammationmetabolic endotoxemiapostbioticsprobioticsrandomized controlled trialstroke

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