A 5-hydroxymethylcytosine-based noninvasive model for acute myocardial infarction in type 2 diabetes: implications in cardiovascular outcomes from a 5-year median follow-up study
Authors' conclusion
Our work indicated specific 5hmC signatures implicated in AMI with T2D background, and provided the foundation for a comprehensive cardiovascular risk management tool for diabetic population.
Study context
- Population
- Patients with T2D with or without acute MI; genome-wide 5hmC mapping in plasma cell-free DNA (cfDNA) (5hmC-Seal)
- Participants
- 225 patients
- Comparison
- 5hmC-based model: T2D + acute myocardial infarction (AMI) vs T2D + non-AMI
- T2D + AMIn = 57
- T2D + non-AMIn = 168reference
- Outcome
- Discrimination of T2D + AMI from T2D + non-AMI by seven-feature weighted 5hmC model
- Follow-up
- Baseline
Methodological detailscross-sectional derivation at baseline, prospective 5-year longitudinal follow-up, training and testing sets
- Cross-sectional derivation at baseline
- Prospective 5-year longitudinal follow-up
- Training and testing sets
Performance
As reported in the abstract
AUC, training set
99.2%
95% CI 98.1–100.0%
AUC, testing set
95.6%
95% CI 89.8–100.0%
Differential 5hmC-gene bodies (P < 0.05) associated with T2D + AMI
255
Further findings
Composite cardiovascular outcomes (CCO) by eSCORE-CARD · median follow-up 5.3 years
- eSCORE-CARD and increased risk of CCO, multivariate Cox HR
- 4.25 (95% CI 1.41-12.80; P < 0.05)
- AUC of eSCORE-CARD combined with SCORE2-Diabetes and SCORE2-OP
- 76.4% (95% CI 65.9-86.8%)
- Multivariate Cox regression
Original publication
A 5-hydroxymethylcytosine-based noninvasive model for acute myocardial infarction in type 2 diabetes: implications in cardiovascular outcomes from a 5-year median follow-up study. Cardiovasc Diabetol. Published 30 January 2026. doi:10.
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