Effect of Gut Microbiota on Metabolic and Inflammatory Biomarkers in Cardiovascular Surgery: A Systematic Review and Meta-Analysis

Background: The gastrointestinal microbiota is pivotal in cardiovascular surgery outcomes. Objectives: This systematic review and meta-analysis aimed to synthesize current evidence regarding the impact of gut microbiota on postoperative metabolomic markers and patient recovery. Methods: Following PRISMA guidelines, a comprehensive query was conducted on 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. Results: 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 c-reactive protein (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. Conclusion: As evidenced by the obtained results, gut microbiota composition significantly affected 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.