Presence of Metabolic Syndrome is not an Independent Predictor of In-hospital Adverse Events in Patients with ST Elevation Myocardial Infarction that Underwent Primary Percutaneous Coronary Intervention

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.