Abstract
Background: Presence of Metabolic Syndrome (MetS) has been shown to predict higher risk for cardiovascular diseases. However, in patients with ST Segment Elevation Myocardial Infarction (STEMI), prognostic importance of MetS has not been widely studied. Methods: We prospectively recruited 611 STEMI patients (521 male, 90 female) who were treated by primary angioplasty. Metabolic syndrome was diagnosed according to the International Diabetes Federation metabolic syndrome worldwide definition. Coronary angiographic data and in-hospital events of individuals were recorded. Major Adverse Cardiac Events (MACE) included cardiac death, recurrent myocardial infarction and target lesion revascularization. Results: Metabolic syndrome group included 276 (45.1% of the study cohort; mean age 56.8 ± 12.2; 210 male) and control group included 335 subjects (54.9% of the study cohort; mean age 55.6 ± 12.9; 311 male). The frequency of female gender, hypertension, Diabetes Mellitus (DM), hyperlipidemia and positive history for coronary artery disease were higher in MetS group, whereas, the ratio of smokers was higher in the control group. The incidence of in-hospital death and MACE was not statistically different in MetS and control groups. Presence of MetS was not correlated with in-hospital death and MACE in univariate analysis. In multivariate analysis using model adjusted for age, gender, DM/ fasting glucose >100 mg/dL, left ventricular ejection fraction, post-PCI TIMI flow grade <3 and high creatinine and peak CK-MB levels age, peak CK-MB and creatinine levels remained the independent predictors of in-hospital mortality. Peak CK-MB and creatinine levels were also independent predictors of in-hospital MACE. Conclusion: Presence of MetS was not a predictor of in-hospital adverse events in patients with STEMI treated with primary percutaneous intervention. Peak CK-MB and creatinine levels may indicate higher risk for in-hospital adverse events.
Highlights
Raised blood pressure, and hypertension (HT), is included in metabolic syndrome (MetS)
In Metabolic Syndrome (MetS) group, the frequency of female gender, HT, Diabetes Mellitus (DM), hyperlipidemia and positive history for coronary artery disease (CAD) were higher, whereas, in patients without MetS frequency of smokers was higher than MetS group
In univariate regression analysis age, gender, DM/fasting glucose >100 mg/dL, left ventricular ejection fraction, post-Percutaneous Coronary Intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) flow grade
Summary
Hypertension (HT), is included in metabolic syndrome (MetS). Metabolic syndrome is a combination of medical disorders that, included HT, obesity, and a prediabetic state (high fasting blood glucose, high triglycerides, and low High Density Lipoproteins (HDL) [1]. It is rapidly increasing in prevalence when occurring together, increase the risk of developing cardiovascular disease (CVD) [1]. The increased risk appears to be related to the risk factor clustering or insulin resistance associated with the MetS rather than to obesity. In patients with ST Segment Elevation Myocardial Infarction (STEMI), prognostic importance of MetS has not been widely studied
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