Prevention of metabolic syndrome implies prevention of severe and multivessel coronary artery disease

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background and Purpose Metabolic Syndrome (MS) is the result of metabolic, clinical, and hemodynamic disturbances caused by a group of cardiometabolic risk factors. The particular components of the syndrome are each individually also a predisposing factor for Coronary Artery Disease (CAD). The purpose of our study is to demonstrate the direct correlation of MS with the angiographic severity of CAD so that by affecting by prevention of one axis of this equation, a favorable effect is automatically achieved on its outcome as well. Methods We have studied 151 patients, 124 males - 27 females of mean age 63.56 ± 11.28 years, who were hospitalized for Acute Coronary Syndrome (ACS) and underwent coronary angiography. MS definition is according to the criteria set by the respective scientific companies. Thus, patients were classified into Group A with MS (46 patients - 35 males, 11 females - mean age 62.07 ± 11.35 years) and Group B without MS (105 patients - 89 males, 16 females – a mean age 65.06 ± 12.54 years). The correlation between MS, and the severity of CAD, has been estimated using the SYNTAX Score. Results Group A patients had a higher incidence of ST-elevation myocardial infarction (STEMI) than Group B patients, namely 32 patients (69.56%) versus 28 patients (26.67%), (p = 0.002), a higher incidence of multivessel disease, 20 patients (43.48%) versus 16 patients (16.8%), (p = 0.02), reduced Ejection Fraction (42.4% ± 9.6% vs. 53.5% ± 6.54% - p = 0.01) and higher SYNTAX Score (19.52 ± 7, 68 vs. 9.64 ± 5.32 - p = 0.01). In Group A with MS, lipid levels disorders were also observed (Total cholesterol, triglycerides, LDL, HDL - p = 0.01), higher values of fasting plasma glucose and HbA1c but also of mean platelet volume (MPV), which is considered a significant prognostic factor in patients with CAD (11.91 ± 1.93 femtolitres vs. 9.84 ± 1.06 femtolitres). Conclusions MS is associated with more severe clinically and angiographically CAD. Prevention and regulation of MS factors are significant for the avoidance of the occurrence of severe coronary syndrome.