Background

The study evaluates how obesity grade is associated with age during the first acute coronary syndrome (ACS) and examines the effect of cardiovascular (CV) risk factors and the age of first ACS in patients with severe obesity.

Methods

We enrolled consecutive patients diagnosed with first episode of ACS between 2014 and 2019, and categorized them by body mass indices (BMI). Severe obesity was defined as BMI ≥35 kg/m². Independent variables affecting the age of first ACS were examined by linear regression analysis.

Results

A total of 1005 patients (mean age, 57.5 ± 12.3 years; 19.3% female) were included. Approximately 6% and 12% of obese patients and normal weight patients had no other risk factors. Patients with ACS with severe obesity were younger than those with ACS in the grade-I obesity, overweight, and normal-weight groups (52.8 ± 9.9 vs. 55.3 ± 10.9, 56.8 ± 11.4, and 61.4 ± 14.2, respectively, p < 0.001). BMI had a strong, inverse linear relationship with earlier age of first ACS. The number of patients with no risk factors was significantly high in normal-weight individuals compared with patients with severe obesity (11.6% vs 5.6%, p = 0.037). After adjusting for CV risk factors, patients with overweight, grade-I obesity, and severe obesity may experience first ACS sooner than those with normal-weight by 3.9, 6.1, and 7.7 years, respectively (p < 0.001). However, males and females with severe obesity without CV risk factors experienced the first ACS episode 16 and 22 years later than those with the highest number of risk factors, respectively.

Conclusion

Patients with severe obesity experience first ACS episode 7.7 years earlier than those with normal-weight. Absence of CV risk factors in people with obesity can improve the potential negative effect of obesity on the ACS age.

Trial registration: NCT04578964, 08 October 2020.

中文翻译：

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肥胖等级与首次急性冠脉综合征年龄之间的关联：前瞻性观察研究

背景

该研究评估了首次急性冠状动脉综合征 (ACS) 期间肥胖等级与年龄的关系，并检查了心血管 (CV) 危险因素和严重肥胖患者首次 ACS 年龄的影响。

方法

我们连续招募了 2014 年至 2019 年间被诊断为首发 ACS 的患者，并按体重指数 (BMI) 对他们进行分类。重度肥胖定义为 BMI ≥35 kg/m ²。通过线性回归分析检查影响首次 ACS 年龄的自变量。

结果

共纳入 1005 名患者（平均年龄 57.5 ± 12.3 岁；19.3% 为女性）。大约 6% 和 12% 的肥胖患者和正常体重患者没有其他危险因素。严重肥胖的 ACS 患者比 I 级肥胖、超重和正常体重组的 ACS 患者年轻（分别为 52.8 ± 9.9 和 55.3 ± 10.9、56.8 ± 11.4 和 61.4 ± 14.2，p  < 0.001 ）。BMI 与第一次 ACS 的早期年龄有很强的反线性关系。与重度肥胖患者相比，正常体重个体中无危险因素的患者数量显着高于重度肥胖患者（11.6% vs 5.6%，p = 0.037)。在调整 CV 危险因素后，超重、I 级肥胖和重度肥胖患者首次 ACS 的发生时间可能比体重正常的患者分别提前 3.9、6.1 和 7.7 年（p  < 0.001）。然而，没有 CV 危险因素的重度肥胖男性和女性首次 ACS 发作的时间分别比具有最多危险因素的男性和女性晚 16 年和 22 年。

结论

重度肥胖患者首次 ACS 发作比体重正常者早 7.7 年。肥胖人群缺乏 CV 危险因素可以改善肥胖对 ACS 年龄的潜在负面影响。

试用注册：NCT04578964，2020 年 10 月 8 日。