2020-08-012024-05-17https://scholars.lib.ntu.edu.tw/handle/123456789/690963The several hundred trillion bacteria harbored in human gastrointestinal tract are referred to as the gut microbiome. Growing evidence suggests that this microbiome is associated with the pathogenesis atherosclerotic cardiovascular disease (ASCVD) which remains one of the leading causes of mortality and morbidity worldwide. ST-segment elevation myocardial infarction (STEMI) is one of the most acute and devastating presentation of ASCVD and is caused mainly by underlying atherosclerotic plaque rupture and thrombosis. The phenomenon of plaque rupture probably reflects an imbalance between the forces impinging on the fibrotic cap and the strength of the cap, and is associated with inflammatory activity of macrophage. As progression of atherosclerosis is found to be associated with gut microbiota or the microbial metabolites, we hypothesized that the phenomenon of plaque rupture may also have a link to gut microbiota or the microbial metabolites. Bacterial DNA has been identified in atherosclerotic plaque. Whether bacteria also reside in the culprit lesion of ACS is unknown. During percutaneous coronary intervention, bacteria may also be aspirated from atherosclerotic plaques by aspiration thrombectomy device. By collecting and analyzing microbial profile from aspirated specimen, oral swab, and fecal material, we may understand if there is any association between microbiota of different body parts. In this study, we plan to enroll 30 adult patients with STEMI in the first and second year as learning and validation cohort, and compare microbial profile from different collect time. This may help us identify microbial profile that is associated with the occurrence of plaque rupture and postulate differential metabolites, the substance X. In the third year, we plan to investigate how the substance X affect the inflammatory activity of macrophage.Atherosclerosismyocardial infarctiongut microbiota