title: Metabolic syndrome and risk of cardiovascular events after myocardial infarction.
abstract: OBJECTIVE
  We aimed to assess the prevalence and prognostic role of metabolic syndrome (METS) and diabetes in post-myocardial infarction (MI) patients.
  
  
  BACKGROUND
  Diabetes is a well known risk factor for patients with previous MI, but glycemic dysmetabolism develops over a protracted period of time. Scanty data are available on the role of METS in patients with previous MI.
  
  
  METHODS
  Adjusted Cox's regression models, having diabetes, death, major cardiovascular events (CVE), and hospitalization for congestive heart failure (CHF) during follow-up as outcome events, were fitted on 11,323 patients with prior MI enrolled in the GISSI-Prevenzione Trial.
  
  
  RESULTS
  At baseline, 21% and 29% of patients had diabetes mellitus and METS, respectively. The METS patients had a significant (93%) increased risk of diabetes during follow-up. As compared with control subjects, the probability of death and CVE were higher in both METS (+29%, p = 0.002; +23%, p = 0.005) and diabetic patients (+68%, p <0.0001; +47%, p <0.0001), although diabetic but not METS patients were more likely to be hospitalized for CHF (+89%, p <0.0003 and +24%, p = 0.241). Moderate (-6% to -10%) and substantial (>-10%) weight reduction were associated with a significant (18% and 41%, respectively) decreased risk of diabetes. Weight gain was significantly associated with increased risk of diabetes. The risk conferred by METS and diabetes tended to be higher among women.
  
  
  CONCLUSIONS
  In patients with MI, METS and diabetes were highly prevalent and are associated with increased risk of death and CVE. Diabetes is also associated with increased risk of hospitalization for CHF. Weight reduction significantly decreased the risk of becoming diabetic in patients with METS.
authors: Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy.
authors: Giacomo
authors: G
authors: Levantesi
authors: Alejandro
authors: A
authors: Macchia
authors: RosaMaria
authors: R
authors: Marfisi
authors: Maria G
authors: MG
authors: Franzosi
authors: Aldo P
authors: AP
authors: Maggioni
authors: Gian L
authors: GL
authors: Nicolosi
authors: Carlo
authors: C
authors: Schweiger
authors: Luigi
authors: L
authors: Tavazzi
authors: Gianni
authors: G
authors: Tognoni
authors: Franco
authors: F
authors: Valagussa
authors: Roberto
authors: R
authors: Marchioli
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D015430:Weight Gain