Metabolic Phenotyping and Follow-Up of Patients With and Without Diabetes After New Onset of STEMI

In detail, the following questions will be answered:

• Do distinct metabolic phenotypes (with respect to insulin secretion, insulin sensitivity, circulating free fatty acids and ectopic lipid storage, especially in the liver) determine myocardial infarct size and decline of contractile function of the remote myocardium?
• Which factors modify the progression of the disease (insulin resistance, ectopic lipid storage, subclinical inflammation, abnormal energy metabolism)? People are thoroughly examined at baseline and one year after STEMI.
• Can we identify risk profiles and their relevance for development of diabetes-associated complications as well as long-term progression of diabetes?
• Can we improve risk assessment algorithms for targeted therapy in line with Precision Medicine?

Inclusion criteria

• Condition after new onset of ST-segment elevation myocardial infarction (STEMI)
• Age 18-80 years
• HbA1c <9.0%
• People with diagnosis of diabetes mellitus according to ADA and DDG criteria (i.e. HbA1c ≥6.5% and/or pathological oral glucose tolerance test)
• Healthy people with normal glucose tolerance status according to ADA and DDG criteria (i.e. HbA1c <5.7% and normal OGTT)
• People with impaired glucose metabolism ("prediabetes") according to ADA and DDG criteria (i.e. impaired fasting glucose and/or impaired glucose tolerance and/or HbA1c 5.7-6.4%)
• Consent-able, hemodynamically stable people, without sedation (e.g. opiates) or other interfering medication (e.g. catecholamines)

Exclusion criteria

• Diabetes mellitus category 3 A-H (ADA criteria), gestational diabetes
• Current pregnancy
• Infectious diseases, acute infections / fever
• Immunosuppressive therapy
• Severe chronic renal, liver or heart disease (e.g. serum creatinin ≥1.6 mg/dl, peripheral artery occlusive disease stage IV)
• Malignant diseases
• Severe chronic psychiatric illness or addiction
• Participation in an intervention trial