Poor recovery of cardiac function in myocardial infarction patients with metabolic syndrome and microalbuminuria.

Abstract

This study aimed to investigate the impact of metabolic syndrome (MetS) with microalbuminuria on the improvement of cardiac function after acute myocardial infarction (AMI). Nondiabetic patients with acute ST segment elevation MI (STEMI) who underwent coronary revascularization from 2013 to 2017 were included. They were grouped according to history of MetS and microalbuminuria test results as follows: microalbuminuria/MetS group, normoalbuminuria/MetS group, microalbuminuria/no MetS group, and normoalbuminuria/no MetS group. Left ventricular ejection fraction (LVEF) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at the 6‑month follow-up were measured and the predictive value of MetS with microalbuminuria on recovery of cardiac function was assessed by multivariable logistic regression modeling. Atotal of 530 STEMI patients were included (average age= 66.6years). Analysis of covariance showed that LVEF recovery in the normoalbuminuria/no MetS group was better than that of the normoalbuminuria/MetS, microalbuminuria/no MetS, and microalbuminuria/MetS groups (49.22% vs. 48.92% vs. 47.48% vs. 46.99%, respectively, p < 0.001) when acute phase LVEF was the covariable. The NT-proBNP level of the normoalbuminuria/no MetS group at the 6‑month follow-up was lower than that of the microalbuminuria/MetS group (p < 0.001). Further regression analysis revealed that there was a lower probability of complete cardiac function recovery after 6months in patients with microalbuminuria (odds ratio: 0.455) than in patients without microalbuminuria (95% CI: 0.316-0.655, p < 0.001). Although post-AMI cardiac function in MetS patients with microalbuminuria can be improved after revascularization, the improvement is not as good as that of patients without microalbuminuria, suggesting that clinical attention should be paid to this subgroup.