Key result
Early-onset ACS is linked to ~61% lower 5-year all-cause mortality compared to late-onset disease.
Why the study?
The effects of metabolic syndrome on onset age and long-term outcomes in patients with acute coronary syndrome were not well understood.
Observational (n=4,602)
No
Metabolic syndrome components (obesity, hypertriglyceridemia, low HDL-C) are independent risk factors for early-onset ACS and are associated with higher incidences of recurrent MI and revascularization.
Answers are grounded in this paper and cite their sources.
Metabolic syndrome components were associated with early-onset ACS and higher recurrent events; leaves open whether targeting them alters onset or prognosis.
BACKGROUND:We aim to investigate eff ects of metabolic syndrome on onset age and long-term outcomes in patients with acute coronary syndrome (ACS). METHODS:Patients with ACS (n=6,431) who underwent percutaneous coronary intervention from January to December 2013 were enrolled.After excluding patients with previous coronary artery disease, 1,558 patients were diagnosed with early-onset ACS (men aged ≤50 years; women aged ≤60 years) and 3,044 patients with late-onset ACS.Baseline characteristics and five-year clinical outcomes were measured.RESULTS: Body mass index, triglyceride, low-density lipoprotein cholesterol, and uric acid concentrations were significantly higher, while the high-density lipoprotein cholesterol (HDL-C) concentration was lower in the early-onset ACS group (P<0.001).Multivariate logistic regression revealed obesity (odds ratio [OR] 1.590, 95% confi dence interval [CI] 1.345-1.881),hypertriglyceridemia (OR 1.403, 95% CI 1.185-1.660),and low HDL-C (OR 1.464, 95% CI 1.231-1.742)as independent risk factors for early-onset ACS (all P<0.001).The fi ve-year follow-up showed that the incidences of all cause death (1.5% vs. 3.8%, P<0.001), cardiac death (1.1% vs. 2.0%, P=0.023), and recurrent stroke (2.2% vs. 4.2%, P<0.001) were lower, while bleeding events were more frequent in the early-onset ACS group.A subgroup analysis showed higher incidences of recurrent myocardial infarction (MI) and revascularization in patients with early-onset ACS and metabolic syndrome.CONCLUSIONS: Obesity, hypertriglyceridemia, and lower HDL-C level are independent risk factors for early-onset ACS, recurrent MI, and revascularization.The control of metabolic syndrome may reduce the incidence of early-onset ACS and improve the long-term prognosis.
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Xu et al. (2020) conducted an observational in Acute coronary syndrome (n=4,602). Early-onset acute coronary syndrome vs. Late-onset acute coronary syndrome was evaluated on All-cause death (p=<0.001). Early-onset acute coronary syndrome was associated with a lower incidence of all-cause death at 5 years compared to late-onset disease (1.5% vs. 3.8%), though metabolic syndrome increased the risk of recurrent events.
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