%0 Multicenter Study
%T Association Between Free Fatty Acids and Cardiometabolic Risk in Coronary Artery Disease: Results From the PROMISE Study.
%A Yuan D
%A Xu N
%A Song Y
%A Zhang Z
%A Xu J
%A Liu Z
%A Tang X
%A Han Y
%A Chen Y
%A Zhang Y
%A Zhu P
%A Guo X
%A Wang Z
%A Liu R
%A Wang Q
%A Yao Y
%A Feng Y
%A Zhao X
%A Yuan J
%J J Clin Endocrinol Metab
%V 109
%N 1
%D 2023 Dec 21
%M 37540767
%F 6.134
%R 10.1210/clinem/dgad416
%X <B>BACKGROUND: </B>The association between free fatty acids (FFAs) and unfavorable clinical outcomes has been reported in the general population. However, evidence in the secondary prevention population is relatively scarce.<BR><B>OBJECTIVE: </B>We aimed to examine the relationship between FFA and cardiovascular risk in patients with coronary artery disease (CAD).<BR><B>METHODS: </B>This study was based on a multicenter cohort of patients with CAD enrolled from January 2015 to May 2019. The primary outcome was all-cause death. Secondary outcomes included cardiac death and major adverse cardiovascular events (MACE), a composite of death, myocardial infarction, and unplanned revascularization.<BR><B>RESULTS: </B>During a follow-up of 2 years, there were 468 (3.0%) all-cause deaths, 335 (2.1%) cardiac deaths, and 1279 (8.1%) MACE. Elevated FFA levels were independently associated with increased risks of all-cause death, cardiac death, and MACE (all P < .05). Moreover, When FFA were combined with an original model derived from the Cox regression, there were significant improvements in discrimination and reclassification for prediction of all-cause death (net reclassification improvement [NRI] 0.245, P < .001; integrated discrimination improvement [IDI] 0.004, P = .004), cardiac death (NRI 0.269, P < .001; IDI 0.003, P = .006), and MACE (NRI 0.268, P < .001; IDI 0.004, P < .001). Notably, when stratified by age, we found that the association between FFA with MACE risk appeared to be stronger in patients aged ≥60 years compared with those aged <60 years.<BR><B>CONCLUSIONS: </B>In patients with CAD, FFAs are associated with all-cause death, cardiac death, and MACE. Combined evaluation of FFAs with other traditional risk factors could help identify high-risk individuals who may require closer monitoring and aggressive treatment.