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Article

Sex-Specific Impact of Different Obesity/Metabolic Phenotypes on Long-Term Cardiovascular Outcomes in Acute Coronary Syndrome Patients

by
Egidio Imbalzano
1,†,
Giuseppina T. Russo
1,†,
Annalisa Giandalia
1,*,
Angela Sciacqua
2,
Luana Orlando
1,
Vincenzo Russo
3,
Maria Perticone
2,
Arrigo F. G. Cicero
4,
Antonio Giovanni Versace
1,
Pierpaolo Di Micco
5,
Vincenzo Antonio Ciconte
6,
Giuseppe Dattilo
1,
Giovanni Squadrito
1 and
Marco Vatrano
6
1
Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
2
Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy
3
Department of Medical Translational Sciences, Division of Cardiology, Monaldi Hospital, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
4
IRCCS Policlinico S. Orsola—Malpighi, Hypertension and Cardiovascular Risk Research Center, DIMEC, University of Bologna, 40126 Bologna, Italy
5
Department of Medicine, Buonconsiglio Fatebenefratelli Hospital, 80100 Naples, Italy
6
UTIC and Cardiology, Hospital “Pugliese-Ciaccio” of Catanzaro, 88100 Catanzaro, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomedicines 2022, 10(2), 424; https://doi.org/10.3390/biomedicines10020424
Submission received: 7 December 2021 / Revised: 4 February 2022 / Accepted: 5 February 2022 / Published: 10 February 2022
(This article belongs to the Special Issue Cardiac and Vascular Diseases: Pathogenesis, Pharmacological Treatments, Advances in Therapies)
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Abstract

Obesity, a major risk factor for acute coronary syndrome (ACS), is a multifaceted disease with different metabolic phenotypes and sex-specific features. Here, we evaluated the long-term cardiovascular risk by different obesity/metabolic phenotypes and by sex in ACS patients. The occurrence of the composite outcome of death, nonfatal reinfarction with or without PCI and/or stroke was evaluated in 674 patients (504 men; 170 women), consecutively hospitalized for ACS and followed-up for 7 years, who were stratified in metabolically healthy (MHNW) and unhealthy normal weight (MUNW), and in metabolically healthy (MHO) and unhealthy obese (MUO) groups. At baseline, 54.6% of patients were included in the MHNW group, 26.4% in the MUNW, 5.9% in the MHO and 13.1% in the MUO, with no sex-differences in the distribution of phenotypes. The overall rate of major outcome (100 person-years) in the reference group (MHNW) was higher in men than in women (RR: 1.19 vs. 0.6). The Kaplan–Meier curves for cumulative survival free from cardiovascular events according to obesity/metabolic status diverged significantly according to sex (log rank test, p = 0.006), this effect being more prominent in men (log 11.20; p = 0.011), than in women (log 7.98; p = 0.047). Compared to MHNW, the risk increased in obese men (RR: 2.2; 95% 1.11–1.54 in MUO group), whereas in women the risk was confined to metabolically unhealthy subjects (RR: 3.2; 95% CI 1.23–9.98, MUNW group). Our data show a sex-specific impact of obesity phenotypes on long-term cardiovascular risk in patients hospitalized for ACS.
Keywords: sex; gender; acute coronary syndrome; metabolically healthy; obesity sex; gender; acute coronary syndrome; metabolically healthy; obesity

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MDPI and ACS Style

Imbalzano, E.; Russo, G.T.; Giandalia, A.; Sciacqua, A.; Orlando, L.; Russo, V.; Perticone, M.; Cicero, A.F.G.; Versace, A.G.; Di Micco, P.; et al. Sex-Specific Impact of Different Obesity/Metabolic Phenotypes on Long-Term Cardiovascular Outcomes in Acute Coronary Syndrome Patients. Biomedicines 2022, 10, 424. https://doi.org/10.3390/biomedicines10020424

AMA Style

Imbalzano E, Russo GT, Giandalia A, Sciacqua A, Orlando L, Russo V, Perticone M, Cicero AFG, Versace AG, Di Micco P, et al. Sex-Specific Impact of Different Obesity/Metabolic Phenotypes on Long-Term Cardiovascular Outcomes in Acute Coronary Syndrome Patients. Biomedicines. 2022; 10(2):424. https://doi.org/10.3390/biomedicines10020424

Chicago/Turabian Style

Imbalzano, Egidio, Giuseppina T. Russo, Annalisa Giandalia, Angela Sciacqua, Luana Orlando, Vincenzo Russo, Maria Perticone, Arrigo F. G. Cicero, Antonio Giovanni Versace, Pierpaolo Di Micco, and et al. 2022. "Sex-Specific Impact of Different Obesity/Metabolic Phenotypes on Long-Term Cardiovascular Outcomes in Acute Coronary Syndrome Patients" Biomedicines 10, no. 2: 424. https://doi.org/10.3390/biomedicines10020424

APA Style

Imbalzano, E., Russo, G. T., Giandalia, A., Sciacqua, A., Orlando, L., Russo, V., Perticone, M., Cicero, A. F. G., Versace, A. G., Di Micco, P., Ciconte, V. A., Dattilo, G., Squadrito, G., & Vatrano, M. (2022). Sex-Specific Impact of Different Obesity/Metabolic Phenotypes on Long-Term Cardiovascular Outcomes in Acute Coronary Syndrome Patients. Biomedicines, 10(2), 424. https://doi.org/10.3390/biomedicines10020424

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