Table 1.
Baseline Characteristics.
Fig 1.
Principal Coordinates Analysis (PCoA) plot illustrating beta diversity in Clusters H and L.
Significant differences in microbiome composition were observed among clusters (PERMANOVA, P < 0.001). Cluster H is depicted in black, whereas Cluster L is depicted in red.
Fig 2.
Incidence of Major Adverse Cardiac Events During Study Follow-Up.
A. Incidence of Major Adverse Cardiac Events (MACE) in gut microbiome clusters: Cluster H exhibited a significantly higher incidence of cardiac events, mortality, and overall MACE compared to Cluster L (all P < 0.05). Although Cluster H had a higher rate of heart failure compared to Cluster L, the difference did not reach statistical significance (P = 0.076). B. Kaplan-Meier curve depicting MACE-free survival in each cluster during follow-up: MACE-free survival was higher in Cluster L compared to Cluster H (P < 0.001). MACE: Major Adverse Cardiovascular Events.
Fig 3.
Gut Microbiome Composition Across Phyla and alpha-Diversity Measures Among Clusters.
A: Box plot displaying the relative abundances of the top 4 abundant phyla across clusters. Cluster H exhibited higher abundances of Bacillota and Actinobacteria, whereas Cluster L showed higher abundances of Bacteroidetes and Proteobacteria. B: Box plot comparing trimethylamine N-oxide (TMAO) levels between clusters. No significant difference in TMAO levels was observed between clusters. C: Box plot comparing operational taxonomic units (OTUs) between clusters. Cluster L displayed a higher mean number of OTUs compared to Cluster H. D: Box plot representing the Chao1 index across clusters. Cluster L demonstrated a significantly higher Chao1 index compared to Cluster H. E: Box plot depicting the Shannon index across clusters. Cluster L exhibited a significantly higher Shannon index compared to Cluster H.
Fig 4.
Linear Discriminant Analysis (LDA) of Clinical Factors Contributing to Gut Microbiome Clustering.
Bar plot showing the LDA scores (log10) of the most influential taxa contributing to cluster separation. Higher LDA scores indicate a greater effect size, reflecting the strength of each taxon’s contribution to distinguishing between clusters. Green bars: Taxa with higher abundance in Cluster L; Red bars: Taxa with higher abundance in Cluster H. * and ** indicate unclassified bacteria of a higher order.