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May 18, 2026JACC AsiaOpen Access

Defecation Patterns and Cardiovascular Outcomes in Acute Coronary Syndrome

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Why the study?

Appropriate defecation patterns may be important for preventing recurrent cardiovascular events, but their association and that of in-hospital laxative use with future cardiovascular events in ACS patients required investigation.

Are abnormal defecation patterns and stimulant laxative use during hospitalization associated with an increased risk of future cardiovascular events in patients with acute coronary syndrome?

Population

1,817 patients hospitalized for ACS

Comparison

Abnormal defecation patterns and laxative use during hospitalization

Design

2-center retrospective observational study

Follow-up

Median 48 months

Key result

Frequent nondefecation days (adjusted HR 1.549; 95% CI 1.217-1.971) and stimulant laxative use during ACS hospitalization were independently associated with increased risk of cardiovascular events.

Authors

YMYasushi MatsuzawaKTKenichi TsujitaTKTakaomi Kessoku

Discussion

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Member takes

Overview

These associations in ACS should not yet change practice; leaves open need for prospective trials to assess causality.

Key Points

  • The aim is to examine the link between defecation patterns and laxative use during hospitalization with future cardiovascular events in ACS patients.
  • 2-center retrospective observational study including 1,817 ACS patients
  • Evaluated defecation patterns such as daily frequency and nondefecation days
  • Primary outcome included all-cause mortality and major cardiovascular events.
  • 20.6% of patients developed the primary outcome during a median follow-up of 48 months
  • Frequent nondefecation days are significant predictors (adjusted HR 1.549; P < 0.001)
  • Stimulant laxative use associated with increased primary outcome risk (adjusted HR 1.285; P = 0.047)

Study Design

Type

Observational (n=1,817)

Multicenter

Yes

Structured PICO

Are abnormal defecation patterns and stimulant laxative use during hospitalization associated with an increased risk of future cardiovascular events in patients with acute coronary syndrome?

P
Population
1,817 patients hospitalized for acute coronary syndrome (ACS)
I
Intervention
Abnormal defecation patterns (frequent nondefecation days ≥33.8%, maximum daily defecation frequency ≥5 times/d) and stimulant laxative use during hospitalization
O
Outcome
Composite of all-cause mortality, myocardial infarction, ischemic stroke, and hemorrhagic stroke at median 48 months follow-upcomposite

Main Result

Effect estimate: HR 1.549 (95% CI 1.217-1.971)

p-value: p=< 0.001

Abnormal defecation patterns and stimulant laxative use during ACS hospitalization are independent predictors of future cardiovascular events.

Cite This Study

Matsuzawa et al. (2026) conducted an observational in acute coronary syndrome (n=1,817). Abnormal defecation patterns and stimulant laxative use was evaluated on composite of all-cause mortality, myocardial infarction, ischemic stroke, and hemorrhagic stroke (HR 1.549, 95% CI 1.217-1.971, p=< 0.001). Frequent nondefecation days (adjusted HR 1.549; 95% CI 1.217-1.971) and stimulant laxative use during ACS hospitalization were independently associated with increased risk of cardiovascular events.

synapsesocial.com/papers/6a0aadf65ba8ef6d83b70d95https://doi.org/10.1016/j.jacasi.2026.01.035
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