Why the study?
STEMI can lead to microvascular obstruction and left ventricular remodeling driven by inflammation and potentially amplified by gut dysbiosis. A multiparametric strategy integrating cardiac magnetic resonance, microbiome profiling, and immuno-inflammatory biomarkers is needed to improve the understanding and prediction of these complications.
Does a multiparametric strategy integrating cardiac magnetic resonance, microbiome profiling, and immuno-inflammatory biomarkers predict 1-year major adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction?
Cohort (n=150)
Blinded outcome adjudication
No
Does a multiparametric strategy integrating cardiac magnetic resonance, microbiome profiling, and immuno-inflammatory biomarkers predict 1-year major adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction?
This prospective cohort study design aims to integrate cardiac MRI, gut microbiome profiling, and inflammatory biomarkers to identify novel predictors of post-STEMI microvascular obstruction, ventricular remodeling, and 1-year clinical outcomes.
Background ST-segment elevation myocardial infarction (STEMI) can lead to complications such as no-reflow/microvascular obstruction (MVO) and left ventricular remodeling (LVR), both with major prognostic impact. Inflammation is central to these mechanisms, and gut dysbiosis may amplify it through elevated trimethylamine N-oxide and lipopolysaccharides. A multiparametric strategy integrating cardiac magnetic resonance (CMR), microbiome profiling and immuno-inflammatory biomarkers may improve the understanding and prediction of these complications. Methods CARAMBOLE is a prospective, single-centre translational cohort study. From March 2024 to July 2025, 150 consecutive STEMI patients at Poitiers University Hospital were included. Eligible patients (≥18 years, confirmed STEMI, informed consent, no CMR contraindication) underwent serial blood sampling and biobanking (plasma, serum, PBMCs, DNA, RNA) at admission, 24 h and 48 h. Faecal and urinary sampling for gut and genitourinary microbiome characterisation, standardised questionnaires (lifestyle, quality of life, cognitive assessment), echocardiography, and CMR were performed during the acute phase and repeated at 1-year follow-up. The primary objective is to identify clinical, biological and imaging biomarkers associated with 1-year major adverse cardiovascular events (MACE: cardiovascular death, recurrent myocardial infarction, ischaemic stroke, heart-failure hospitalisation), adjudicated by an independent blinded committee. Multi-omic analyses (shotgun metagenomics, targeted metabolomics, high-plex inflammatory proteomics) are pre-specified as exploratory and several are contingent on additional funding. Conclusions This multiparametric, translational cohort will provide new mechanistic and epidemiological insights into the relationships among dysbiosis, inflammation, and CMR markers (no-reflow/MVO, infarct size, LVR), with the goal of generating prognostic biomarker hypotheses to be validated in larger, multicentre cohorts.
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Pichon et al. (2026) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=150). Multiparametric CMR, microbiome profiling, and immuno-inflammatory biomarkers was evaluated on 1-year major adverse cardiovascular events (MACE: cardiovascular death, recurrent myocardial infarction, ischaemic stroke, heart-failure hospitalisation).
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