Although lipid metabolism and gut microbiota dysregulation are known to participate in cardiovascular disease, few studies have examined these alterations and associations in acute myocardial infarction (AMI) patients. This study reveals altered and associated lipid metabolism and gut microbiome based on proteomic and lipidomic analyses of fecal and plasma samples from 30 patients with AMI and 33 healthy volunteers. Twenty-three differential plasma lipids, nine altered fecal lipids, and nine differential fecal bacterial species were identified in AMI patients relative to healthy volunteers, with nine plasma lipids, three fecal lipids, and two fecal bacteria as potential biomarkers. Correlation analysis revealed that the abundances of