Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2018 02 13() pii S1109-9666(17)30540-7
The aim of this study is to evaluate the impact of metabolic syndrome (MetS) on clinical severity and long term prognosis in patients with myocardial infarction with ST segment elevation (STEMI).
We examined 507 patients with STEMI who were admitted for primary percutaneous coronary intervention classified according to the presence of MetS using American Heart Association and the National Heart, Lung and Blood Institute definition. After applying these criteria, the patients were categorized in patients with MetS and without MetS. We compared baseline characteristics, clinical findings and outcomes among these patients. During the 48-month follow up we collected data about Major Adverse Cardiac Events (MACE) and mortality.
MetS was present in 217 patients (mean age 60.71 ± 11.52; 59 female) while a control group consisted of 290 subjects (mean age 57.50 ± 10.95; 54 female). The patients with and without MetS, had similar parameters of clinical severity of STEMI but differed in severe coronary artery disease. During the follow up period a significant percentage of myocardial infarction (6, 91% vs 2, 06%) and new revascularization(16,59% vs 8,97 %,) was recorded in MetS group. On multivariate analysis MetS was independently associated with MACE (HR 1.834, 95%CI 1.162-2.896, p=0.009) but not with mortality (HR 1.603, 95%CI 0.864-2.973, p=0.134). Among cardiovascular events that compose MACE, MetS was associated with new revascularization (HR 2.204, 95%CI 1.273-3.815; p=0.005).
The presence of MetS in patients with STEMI is independent risk factor for MACE, and this syndrome is strongly associated with new revascularization.