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Background <p>Humans with type 2 diabetes and/or metabolic dysfunction-associated steatotic liver disease (MASLD) are at higher risk of ST-segment elevation myocardial infarction (STEMI) and worse prognosis. However, mechanisms, prognostic factors and risk subtypes in humans with STEMI and (pre)diabetes with or without MASLD, are not fully understood.</p> Methods <p>The DIabetes and ST-segment Elevation Myocardial Infarction (<i>DISTEMI</i>) study is a prospective longitudinal cohort study, recruiting humans with different degrees of glucose tolerance after recent STEMI. This cohort study has the primary objective to detect changes in glycemia and insulin sensitivity derived from the oral glucose tolerance test (OGTT) and their relationships to cardiac function. Secondary objectives address tissue-specific insulin sensitivity and organ function, focusing on adipose tissue, liver and heart. Exploratory objectives comprise multiomic analyses and measures of mitochondrial function and quality of life. At 2 and 12&#xa0;months after STEMI, participants undergo comprehensive cardiometabolic phenotyping (OGTT, modified Botnia clamp-test, magnetic resonance imaging/spectroscopy/elastography, high-resolution respirometry). Magnetic resonance-based techniques are employed to assess cardiovascular function and structure, adipose tissue distribution, skeletal muscle and hepatic lipid deposition and fibrosis, and hepatic energy metabolism. Exploratory analyses include multiomics of blood, urine, and stool samples. Multiomics analyses shall allow detecting biomarkers for stratification of cardiovascular disease risk. Currently, 100 participants have been included in <i>DISTEMI</i>, of whom 29% have type 2 diabetes.</p> Conclusion <p>The <i>DISTEMI</i> study integrates comprehensive cardiometabolic phenomic with multiomic profiling to identify cardiometabolic STEMI subtypes and predictors of outcomes, and to improve precision risk stratification and targeted prevention.</p> Trial registration <p>NCT05046483</p> Graphical Abstract <p></p>

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Cohort profile: The DIabetes and ST-segment Elevation Myocardial Infarction (DISTEMI) Study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月13日

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  • Clara Möser,
  • Katsiaryna Prystupa,
  • Martin Schön,
  • Iryna Yurchenko,
  • Kálmán B. Bódis,
  • Maximilian Huttasch,
  • Filippo Michelotti,
  • Yuliya Kupriyanova,
  • Vera Schrauwen-Hinderling,
  • Cesare Granata,
  • Gidon J. Bönhof,
  • Alexander Strom,
  • Christian Herder,
  • Daniel Dörr,
  • Sandra Trenkamp,
  • Geronimo Heilmann,
  • Pavel Bobrov,
  • Klaus Straßburger,
  • Julia Szendroedi,
  • Mareike Cramer,
  • Amin Polzin,
  • Christian Jung,
  • Malte Kelm,
  • Volker Burkart,
  • Robert Wagner,
  • Michael Roden,
  • Oana-Patricia Zaharia

摘要

Background

Humans with type 2 diabetes and/or metabolic dysfunction-associated steatotic liver disease (MASLD) are at higher risk of ST-segment elevation myocardial infarction (STEMI) and worse prognosis. However, mechanisms, prognostic factors and risk subtypes in humans with STEMI and (pre)diabetes with or without MASLD, are not fully understood.

Methods

The DIabetes and ST-segment Elevation Myocardial Infarction (DISTEMI) study is a prospective longitudinal cohort study, recruiting humans with different degrees of glucose tolerance after recent STEMI. This cohort study has the primary objective to detect changes in glycemia and insulin sensitivity derived from the oral glucose tolerance test (OGTT) and their relationships to cardiac function. Secondary objectives address tissue-specific insulin sensitivity and organ function, focusing on adipose tissue, liver and heart. Exploratory objectives comprise multiomic analyses and measures of mitochondrial function and quality of life. At 2 and 12 months after STEMI, participants undergo comprehensive cardiometabolic phenotyping (OGTT, modified Botnia clamp-test, magnetic resonance imaging/spectroscopy/elastography, high-resolution respirometry). Magnetic resonance-based techniques are employed to assess cardiovascular function and structure, adipose tissue distribution, skeletal muscle and hepatic lipid deposition and fibrosis, and hepatic energy metabolism. Exploratory analyses include multiomics of blood, urine, and stool samples. Multiomics analyses shall allow detecting biomarkers for stratification of cardiovascular disease risk. Currently, 100 participants have been included in DISTEMI, of whom 29% have type 2 diabetes.

Conclusion

The DISTEMI study integrates comprehensive cardiometabolic phenomic with multiomic profiling to identify cardiometabolic STEMI subtypes and predictors of outcomes, and to improve precision risk stratification and targeted prevention.

Trial registration

NCT05046483

Graphical Abstract