{Reference Type}: Multicenter Study
{Title}: Association Between Free Fatty Acids and Cardiometabolic Risk in Coronary Artery Disease: Results From the PROMISE Study.
{Author}: Yuan D;Xu N;Song Y;Zhang Z;Xu J;Liu Z;Tang X;Han Y;Chen Y;Zhang Y;Zhu P;Guo X;Wang Z;Liu R;Wang Q;Yao Y;Feng Y;Zhao X;Yuan J;
{Journal}: J Clin Endocrinol Metab
{Volume}: 109
{Issue}: 1
{Year}: 2023 Dec 21
{Factor}: 6.134
{DOI}: 10.1210/clinem/dgad416
{Abstract}: <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.