Low rates of exercise in patients with metabolic syndrome after an acute coronary syndrome.
BACKGROUND
Metabolic syndrome (MetSyn) has reached epidemic proportions; however, regular exercise can prevent its progression to type 2 diabetes.


OBJECTIVE
The study was undertaken to determine both the rate and predictors of routine exercise 1 year after an acute coronary syndrome (ACS) in patients with MetSyn.


METHODS
In a registry of 1,199 patients presenting with ACS, those with MetSyn were identified using the modified NCEP-ATP III criteria. Baseline and 1-year exercise patterns were examined in these patients, and the characteristics of those who were exercising were then compared with those who were not. A multivariable logistic regression analysis was subsequently conducted to identify independent predictors of exercise at 1 year.


RESULTS
Of 273 patients with MetSyn, baseline and 1-year data about patients' exercise patterns were available for 170, of whom only 92 (54.2%) were exercising at 1 year. Characteristics that differed between those who were and those who were not exercising at 1 year included exercise at baseline (40 vs. 16.7%, p<0.001), Caucasian race (92.4 vs. 79.5%, p = 0.01), and body mass index (BMI) (30.4 +/- 4.3 vs. 32.1 +/- 5.0, p = 0.02). In a multivariable analysis, significant independent predictors of exercise were routine exercise at the time of admission for ACS (odds ratio [OR] = 2.6,95% confidence interval [CI] = 1.1-6.4), younger age (OR = 0.67 per 10-year increase [95% CI = 0.45-0.99]), and lower BMI (OR = 0.4 per 10-unit increase [95% CI = 0.17-0.911).


CONCLUSIONS
Almost half of patients with MetSyn did not participate in routine exercise 1 year after their admission for ACS. Innovative strategies are needed to increase exercise participation in such patients, particularly those not exercising at baseline as well as obese and older patients.
Abuissa
Hussam
H
Mid America Heart Institute, Cardiovascular Consultants, 4330 Wornall Road, Suite 2000 Kansas City, MO 64111, USA. abuissah@umkc.edu
Khanna
Avinash
A
Spertus
John
J
D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003327:Coronary Disease / Q000503:physiopathology*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012107:Research Design; D013577:Syndrome; D044465:White People