Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.


Before the heart attack

An Author Correction to this article was published on 09 March 2022

This article has been updated

Integrated analysis of microbiome and metabolome profiles in unique cohorts reveals early and late markers of the transition towards ischemic heart disease.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Overview of changes in microbial pathways in different strata of healthy individuals, metabolically matched control individuals (with metabolic dysregulation but without IHD) and patients with IHD.

Change history


  1. Fromentin, S. et al. Nat. Med. (2022).

  2. Talmor-Barkan, Y. et al. Nat. Med. (2022).

  3. Canfora, E. E., Meex, R. C. R., Venema, K. & Blaak, E. E. Nat. Rev. Endocrinol. 15, 261–273 (2019).

    CAS  Article  Google Scholar 

  4. Tang, W. H. et al. N. Engl. J. Med. 368, 1575–1584 (2013).

    CAS  Article  Google Scholar 

  5. Haak, B. W. et al. Transl. Stroke Res. 12, 581–592 (2021).

    CAS  Article  Google Scholar 

  6. Forslund, S. et al. Nature (2021).

    Article  PubMed  Google Scholar 

  7. Meijers, B. K. I. et al. Kidney Int. 73, 1174–1180 (2008).

    CAS  Article  Google Scholar 

  8. Depommier, C. et al. Nat. Med. 25, 1096–1103 (2019).

    CAS  Article  Google Scholar 

  9. Zhao, L. et al. Science 359, 1151–1156 (2018).

    CAS  Article  Google Scholar 

  10. Wagner, R. et al. Nat. Med. 27, 49–57 (2021).

    CAS  Article  Google Scholar 

  11. Blaak, E. E. Proc. Nutr. Soc. 79, 331–337 (2020).

    CAS  Article  Google Scholar 

  12. Verdonschot, J. A. J. et al. Eur Heart J. 42, 162–174 (2021).

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ellen E. Blaak.

Ethics declarations

Competing interests

W.M.d.V. is a cofounder of and has stock in A-mansia Biotech, which is commercializing the gut bacterium Akkermansia muciniphila. E.E.B. declares no competing interests.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Blaak, E.E., de Vos, W.M. Before the heart attack. Nat Med 28, 237–238 (2022).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing