Tian R, Liu H, Feng S, et al. - Since patients with stable coronary artery disease combined with type 2 diabetes have significantly higher risk for a cardiac event, researchers assessed how microbiota impacts the development of cardiometabolic disease. They applied multi-omics analyses (metagenomics and metabolomics) of fecal and serum samples from a prospective cohort including stable coronary artery disease combined diabetes mellitus (SCAD+T2DM, n = 38), stable coronary artery disease (SCAD, n = 71), and healthy controls (HC, n = 55). Bacterial and metabolic signatures were significantly different between SCAD and SCAD+T2DM groups. Higher levels of aromatic amino acids and carbohydrates, which correlate with a gut microbiome with enriched biosynthetic potential, characterized SCAD+T2DM individuals. They also discovered that specific bacterial taxa Ruminococcus torques predicted cardiac survival outcomes. The results distinguished the associations between features of the gut microbiota and circulating metabolites, providing a new direction for future studies intending to understand the host–gut microbiota interplay in atherosclerotic cardiovascular pathogenesis.