The following is a summary of “Association Between Free Fatty Acids and Cardiometabolic Risk in Coronary Artery Disease: Results From the PROMISE Study,” published in the January 2024 issue of Endocrinology by Yuan, et al.

While the relationship between free fatty acids (FFAs) and adverse clinical outcomes is acknowledged in the general population, there is a scarcity of evidence concerning this association in patients undergoing secondary prevention measures. For a study, researchers sought to explore the correlation between FFA levels and cardiovascular risk in individuals diagnosed with coronary artery disease (CAD).

Data from a multicenter cohort of CAD patients enrolled between January 2015 and May 2019 were analyzed. The primary endpoint examined was all-cause mortality, while secondary outcomes encompassed cardiac mortality and major adverse cardiovascular events (MACE), defined as a composite of death, myocardial infarction, and unplanned revascularization.

Over a 2-year follow-up period, there were 468 (3.0%) all-cause deaths, 335 (2.1%) cardiac deaths, and 1,279 (8.1%) MACE. Elevated FFA levels independently correlated with heightened risks of all-cause mortality (P < .05), cardiac mortality (P < .05), and MACE (P < .05). Integrating FFA levels with an original Cox regression model significantly enhanced discrimination and reclassification for predicting all-cause mortality (NRI 0.245, P < .001; IDI 0.004, P = .004), cardiac mortality (NRI 0.269, P < .001; IDI 0.003, P = .006), and MACE (NRI 0.268, P < .001; IDI 0.004, P < .001). Intriguingly, the association between FFAs and MACE risk appeared more pronounced in patients aged ≥60 years compared to those aged <60 years.

Among CAD patients, elevated FFAs are associated with increased risks of all-cause mortality, cardiac mortality, and MACE. Incorporating FFA assessment alongside conventional risk factors could aid in identifying high-risk individuals who may necessitate more intensive monitoring and therapeutic interventions.

Reference: academic.oup.com/jcem/article-abstract/109/1/125/7237387