Smoking is a more dangerous risk factor than metabolic syndrome in Egyptian patients with acute myocardial infarction

Abstract

The effect of metabolic syndrome (MS) and other risk factors of myocardial infarction (MI) are not consistent in all studies. Aim: To assess the incidence of each risk factor in our community as a predictor of acute myocardial infarction. Methods: Fifty patients (Pts) admitted to the main university hospital with acute myocardial Infarction were studied. All risk factors were recorded as well as echocardiographic measurements. Metabolic syndrome components were defined as detailed in the ATP III report: (1) waist circumference >102 cm in men and > 88 cm in women, (2) fasting triglycerides ⩾ 150 mg/dl, (3) HDL cholesterol <40 mg/dl in men and < 50 mg/dl in women, (4) blood pressure ⩾ 130/85 mmHg, and (5) fasting – glucose ⩾ 110 mg/dl. Participants with at least three of these components were determined to have the MS. MS was present in 27 pts (54%). The incidence of different risk factors in the 50 pts: Family history of any point as before age 60 as coronary disease, sudden death, diabetes, Ht was present in 36 pts (72%), smoking (current or stopped less than 6 months 38 pts (76%)). Comparison of those with MS vs. those without: Male to female ratio: Not significant (NS), Diabetes present/absent: 21/6 vs. 9/14, p = 0.005; HT : 18/9 vs. 6/17, p = 0.004; Smoking 18/9 vs. 20/3, p = 0.09; family history of any major risk factor including sudden death or premature coronary disease: 21/6 vs. 16/7, p = NS; BMI > 30 : 14/13 vs. 5/18, p = 0.02; waist > 102, 88 in m and f respectively: 18/9 vs. 7/14, p = 0.01. Comparison with Egyptian prevalence: data in our study vs. prevalence in Egypt above age 15 yr respectively: Diabetes: 30 (60%) vs. 10%, p = 0.000; HT 24 (48%) vs. 26%, p = 0.007; smoking 76% vs. 40 in males, p = 0.000; Ms 27 (54%) vs. 24%, p = 0.0003. Smoking was the highest risk factor among pts with acute MI (76%0 followed by positive family history (72%) then diabetes (60%), metabolic s. (54%), HT (48%). We highlight the danger of smoking beside other factors as predictors of MI in Egyptian population.