Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 11 3 0202 05 06 268 281 EN Maryam Shakiba Guilan University of medical sciences Arsalan Salari Cardiovascular Diseases Research Center, Guilan University of medical sciences Sima Masudi Urmia University of Medical sciences Salman Nikfarjam Cardiovascular Diseases Research Center, Guilan University of medical sciences marjan mahdavi Roshan Cardiovascular Diseases Research Center, Guilan University of medical sciences elnaz abhari Cardiovascular Diseases Research Center, Guilan University of medical sciences yasaman borgheie Cardiovascular Diseases Research Center, Guilan University of medical sciences 2025 02 10 2025 05 18 Introduction: The aim of this study was to explore latent classes of risk factors among patients with acute coronary syndrome. Methods: A cross-sectional study was performed on patients with symptoms of chest pain, unstable angina, or myocardial infarction who had at least one coronary vascular involvement confirmed by angiography. A latent class analysis (LCA) using five categorical risk factors, including metabolic syndrome, physical activity, tobacco use, alcohol, and opium consumption, was conducted on 380 eligible patients. A logistic regression model was used to explore the associations of demographic and clinical variables with latent classes. Results: The mean age of the patients was 59.05 years (SD= 9.82). A two-class model showed the best fit; Class I (45.1%) was characterized by a high probability of smoking, alcohol, and opium consumption, and Class II was characterized by a high probability of metabolic syndrome (54.9%). There was a significant difference between the two classes in terms of age, sex, job, and educational status. The multiple logistic regression model revealed that age and sex were independent predictors of latent class membership. Conclusion: This study revealed two distinct latent risk factor patterns among ACS patients emphasizing the need for personalized prevention approaches. Behavioral interventions should be prioritized in younger patients. While, sex-specific metabolic syndrome management strategies should be underscored in older patients. https://jbe.tums.ac.ir/index.php/jbe/article/view/1601