In recent years, the incidence of Acute Coronary Syndrome (ACS) has been increasing worldwide. Although modified risk factors are well established, the combined contribution of lifestyle factors to ACS has not been extensively studied. This study aimed to examine multidomain lifestyle factors associated with ACS by developing a preliminary lifestyle composite. A pilot case-control study was conducted using data from 55 ACS cases and 55 healthy controls. Lifestyle factors were assessed using a questionnaire including the Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scales (DASS-21), Food Habits Questionnaire (FHQ), Night Eating Diagnostic Questionnaire (NEDQ), and the Global Physical Activity Questionnaire (GPAQ). The hypothesis was analyzed using a bivariate test, followed by binary logistic regression. Bivariate analysis identified educational level (p=0.019), comorbidities (p<0.001), body mass index (p=0.037), stress level (p=0.001), sleep quality (p=0.004), night eating patterns (p<0.001), fat consumption, and physical activity (p<0.000) associated with ACS incidence. A preliminary composite lifestyle score was constructed and was strongly associated with ACS incidence (p<0.001). Multivariable logistic regression further confirmed that preliminary composite lifestyle risk, comorbidities, age, and BMI independently predicted ACS occurrence, with comorbidities (OR=16.69; 95% CI:4.05-68.67) and lifestyle risk (Wald X2=17.2), followed by BMI (OR=3.15; 95% CI:1.21-8.22) and age (OR=2.82; 95% CI:1.46-5.45). The preliminary composite lifestyle score demonstrated a strong association with ACS Status, and warrants validation in larger, prospective cohorts before clinical application.
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