[duffpkg]

The article differs substantively from the actual conclusions of the study. This study shows a minor correlation in some bacterial DNA "signatures" in arterial plaque in about 200 people (~40% had the correlated bacteria). The study only included tissues from people who died of heart disease or had surgery related to heart disease. There does not currently appear to be a strong baseline about how widespread this bacterial signature may exist in a broad population regardless of health.

In a nutshell there is a slightly interesting idea that deserves further study. That's it.

[lithocarpus]

Interesting.

So, one could make a similar article saying "Myocardial infarction may be caused by sugar consumption" and support it by analyzing the recent diet of 200 people who died of heart disease and finding that 95% of them recently consumed a lot of sugar.

[brandonb]

This study's main contribution was to identify the specific bacteria, which gives insight into the mechanism behind heart attacks (the antibody the researchers developed was one of their central contributions). So the researchers dissected only people who died of heart disease.

I think a population study to assess the odds ratios of a risk factor on people who die of heart disease vs not would be valuable (but is a very different beast).

[motorest]

> So, one could make a similar article saying "Myocardial infarction may be caused by sugar consumption" (...

One could apply the same flawed logic to claim that propensity for myocardial infarction may cause certain bacterial infections.

[itsoktocry]

Try it and see where you get, since you assume these scientists are so foolish.

[monero-xmr]

Isn’t it obvious that a heart attack could be caused by a myriad of issues? Sure a bacteria could be a cause. So could be genetics, or an excess of cheeseburgers. A heart ceasing to pump blood effectively is not a singular cause

[lithocarpus]

Exactly, it's complex.

"we found some bacteria in people with heart disease, let's try killing the bacteria" is really bad logic.

Like another commenter posted it's similar to saying a lot of house fires had fire trucks in front of them, let's do some trials where we destroy some of the fire trucks to see if that helps.

[motorest]

> Isn’t it obvious that a heart attack could be caused by a myriad of issues?

I think you not only missed the point but also are doubling down on your mistake by conflating correlation with causality. You don't conclude that burger craving is caused by owning a car by observing drive-through restaurants.

[BigJono]

I might be reading parts of it wrong, but I think that's a different sort of thing to the research in the article.

Sugar is a very indirect cause of heart attacks, everyone knows that most heart attacks are a culmination of decades of diet and exercise habits. It's still worth researching everything to do with that, but it's pretty low value research because it's hard to draw any actionable conclusions from it other than "eat healthier and exercise", which is already well known.

The research in the article is talking about a direct cause. Bacteria exists on arterial plaque, viral infection triggers bacteria to multiply, something about that process causes the plaque to detach and cause a heart attack. If that ends up being a rock solid cause and effect, even for a subset of heart attacks, that could lead to things like direct prevention (anti-virals before the heart attack happens) or changes in patient management (everyone with artery disease gets put far away from sick patients) that could directly and immediately save a lot of lives.

The post you replied to was saying that the data from the study isn't as strong as the article and headline make it out to be, which is usually the case. For this one though I'm reading that less as "it's a nothingburger" and more as "it's a small interesting result that needs a lot of follow up".

[lithocarpus]

While you're not technically wrong, I find this whole approach to be not good.

And actually, if as a lot of science is now suggesting, inflammation and damage due to eating oxidization-prone lipids (aka refined oils) in combination with refined sugar is a big part of the cause of arterial damage and heart disease, that could be easily be the biggest root cause in most of these cases. The bacteria if they even play a causal role at any point, could be a result of previous damage due to diet (and lack of exercise).

The paper's idea of treating heart disease by giving patients antibiotics seems really problematic to me. Destroy your health with poor diet and lack of exercise, and then once you start to feel the effect of this, take antibiotics and destroy your gut health too.

[navigate8310]

While do do agree with the general premise of your comment, that is, correct the root cause. For some, "eat healthy and exercise", may not be an option, because they are already addicted and overweight. At least, taking anti-biotics could be the very first line of actionable treatment to prevent the bacterial buildup and save their life immediately.

[lithocarpus]

I very strongly disagree. Antibiotics are very dangerous at the individual level in how they mess up the individual's gut bacteria which are crucial for health.

Furthermore giving everyone antibiotics as a preventative measure for heart disease complications, given that most Americans are on the spectrum of heart disease (i.e. have hypertension) is a recipe for bacterial resistance and other population problems.

[bluGill]

If you atempt that plan at scale I would expect antibiodic restistant bacteria to develop fast and people soon start dieing younger of what we now think of as minor infections.

[rdedev]

Are there any human randomised control trials that show stuff like vegetable oil cause inflammation? Atleast the ones I've seen show the opposite

https://youtu.be/-xTaAHSFHUU

[lithocarpus]

No, such human rcts haven't been done.

The mechanism for how refined linoleic acid if heated would create higher amounts of free radicals that are known to cause oxidative stress / inflammation is well understood.

I agree a large scale rct for this would be great, but I doubt anyone would fund it and if it does get done I'd be surprised if it wasn't designed to meet the biases of the side that funds it.

[rawgabbit]

Minor correlation? P values are small indicating a strong correlation?

      Quote:  Of the bacteria detected, oral viridans group streptococcal DNA was the most common, being found in 42.1% of coronary plaques and 42.9% of endarterectomies.  Immunopositivity for viridans streptococci correlated with severe atherosclerosis (P<0.0001) in both series and death from coronary heart disease (P=0.021) or myocardial infarction (P=0.042).

[teraflop]

This is a super common misconception, but a small p-value does *not* (necessarily) mean a strong correlation. It means high confidence that the correlation is non-zero.

[rawgabbit]

Yes. I understand that. I was questioning the original assertion that there was a “minor” correlation. The p values indicate a correlation. One that is statistically significant.

[teraflop]

Late response, but the whole point is that "statistically significant" doesn't necessarily mean "major", because significance is as much about the experimental design as it is about the thing you're measuring.

Imagine, for the sake of argument, that being left-handed is correlated with a 0.001% higher likelihood of accidentally dropping your car keys every time you pick them up. An experiment studying a small sample of people for a month probably wouldn't detect this correlation at all. If you ran the same experiment but carefully monitored every single person in the US around the clock, you would be able to reliably detect it with an extremely small p-value. And yet it's still fair to describe it as an extremely minor correlation.

[raincole]

P value means "if the null hypothesis were true, the probability we would have observed what we actually observed."

It's definitely not the strength of correlation. It's not even the probability that the opposite of the null hypothesis is false!

[cluckindan]

That’s what it means in the literal sense. As a more practical interpretation, p value is the ”probability that the observed result was due to random chance instead of the suggested hypothesis”

[drgo]

.. and only if myriad of other assumptions (many are unstated) hold.

[DaveZale]

yes from tfa:

What Question Should Be Addressed Next?

• Could a short‐term antibiotics treatment given at the acute phase affect the outcome of myocardial infarction, and would it be possible to develop new diagnostic imaging and prevention methods for bacterial biofilm?

[lithocarpus]

I think the first question to be addressed should be, does the general population have similar prevalence of this bacteria?

I didn't read the article but just based on the parent comment, it sounds like this baseline hasn't yet been established. It seems very wrong to start testing antibiotics without first establishing the baseline of whether everyone has this bacteria.

[DaveZale]

another possibility that was floated in the TFA was vaccination. The whole point of the article was to precisely map out a mechanism, beyond that, many possibilities exist for intervention or prevention.