Predictive value of plasma indoxyl sulfate for long-term outcomes of the patients with unstable angina pectoris

TIAN Ya-nan; SONG Hai-jiu; WANG Si-bo; ZHANG Wen-jing; ZHANG Zhi-hong

doi:10.3969/j.issn.1672-5301.2025.07.011

Abstract：Objective Present study evaluated the predictive value of indoxyl sulfate(IS)what a type of gut microbiota-derived metabolites on outcomes of patients with unstable angina pectoris(UA).Methods A total of 320 patients who diagnosed with UA from January to December in 2019 were selected consecutively.The levels of plasma IS were determined by targeted liquid chromatography/mass spectrometry.The follow-up time was 3 year and the follow-up endpoint was a major adverse cardiac and cerebrovascular event(MACCE).The patients with UA were divided into three groups:high IS group(0.14-0.53 μg/ml),medium IS group(0.54-1.13 μg/ml)and low IS group(1.14-4.57 μg/ml)according to the IS quantile.Results There were statistically significant differences in IS between the three groups(P<0.05).During the follow-up period,rate of MACCE was higher in the high IS group than in the low IS group and the medium IS group(21%vs.4.7%vs.13.9%,P<0.05).Survival analysis showed that,the cumulative survival rate of the group with high IS without MACCE was lower than that of the group with low IS and medium IS(F=11.697,P=0.003).Cox regression showed that IS(HR=1.60,95%CI 1.20-2.14,P=0.001)was independently associated with the occurrence of MACCE in patients with ACS and high IS(1.14-4.57 ug/ml)(HR=4.31,95%CI 1.63-11.38,P=0.003)was an independent risk factor for MACCE in patients with UA.The area under the ROC curve in terms of IS and combination of IS and age,low density lipoprotein cholesterol predicting MACCE was 0.675(95%CI 0.593-0.757,P<0.001)and 0.800(95%CI 0.730-0.869,P<0.001),respectively.Conclusions Our study demonstrates that IS is independently correlated with the occurrence of MACCE in patients with UA.The combination of IS,age,and low-density lipoprotein has a significant predictive value for the prognosis.