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A new study led by the CNIC has identified imidazole propionate (ImP), a metabolite produced by gut bacteria, as a driver of atherosclerosis— as a driver of atherosclerosis, the disease behind most heart attacks and strokes Cardiovascular disease remains the world’s leading cause of death, and often originates in atherosclerosis, a chronic condition in which inflammation and fat deposits cause arteries to harden and narrow. Although clinical practice already targets causal factors like high cholesterol, hypertension, and smoking, detecting atherosclerosis in its early stages continues to be a significant challenge. Now, researchers at the Spanish National Center for Cardiovascular Research (CNIC) have identified a gut microbiota–derived metabolite, imidazole propionate (ImP), that appears in the blood during the early stages of active atherosclerosis.