Multimorbidity in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Multimorbidity, the presence of multiple long-term conditions, complicates the management of acute coronary syndrome (ACS).
• Understanding the prevalence and impact of multimorbidity in ACS is crucial for optimizing patient care and outcomes.

Purpose of the Study:

• To determine the prevalence of multimorbidity in patients with ACS.
• To assess how multimorbidity influences the clinical management and outcomes of ACS patients.

Main Methods:

• A systematic review and meta-analysis of studies published up to July 2024.
• Searched Medline, Web of Science, Embase, and Cochrane databases.
• Included studies reporting multimorbidity prevalence in ACS or stratified ACS outcomes by multimorbidity status; employed random-effects meta-analysis.

Main Results:

• Pooled prevalence of multimorbidity in ACS was 46.6% (95% CI: 38.9%-54.2%) across 41 studies.
• Multimorbidity was linked to reduced use of invasive management and secondary preventative medications.
• Associated with increased short-term (RR 1.43) and long-term mortality (RR 1.87), with each additional condition increasing mortality risk by 16%.

Conclusions:

• Multimorbidity is a common condition in ACS patients.
• Patients with multimorbidity receive less guideline-directed therapy.
• Multimorbidity significantly worsens clinical outcomes and survival in ACS patients.