title: Impact of metabolic syndrome on myocardial perfusion grade after primary percutaneous coronary intervention in patients with acute ST elevation myocardial infarction.
abstract: OBJECTIVE
  Metabolic syndrome with its associated cardiovascular risk factors and prothrombotic, procoagulant and proinflammatory properties and its detrimental effects on coronary microcirculation may play a role in the occurrence of poor myocardial perfusion after primary percutaneous coronary intervention in patients with acute myocardial infarction. Accordingly, this study was designed to evaluate the association between metabolic syndrome and myocardial perfusion grade in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
  
  
  METHODS
  The study population included 283 consecutive patients (229 men, mean age=62+/-8 years) admitted to our hospital with ST-elevation myocardial infarction and who underwent primary percutaneous coronary intervention. Thrombolysis in myocardial infarction (TIMI) myocardial perfusion grade (TMPG) was graded densitometrically on the basis of visual assessment of relative contrast opacification of the myocardial territory subtended by the infarct vessel in relation to epicardial density. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients were divided into two groups on the basis of the myocardial perfusion grade determined after percutaneous coronary intervention. Group I consisted of 223 patients with good myocardial perfusion (TMPG 2-3) after successful percutaneous coronary intervention and group II of 60 patients with poor myocardial perfusion (TMPG 0-1).
  
  
  RESULTS
  The prevalence of metabolic syndrome was found to be significantly higher in patients with poor myocardial perfusion than in those with good myocardial perfusion (40 vs. 20%, respectively, P=0.002). Moreover, we detected an independent association between metabolic syndrome and the occurrence of poor myocardial perfusion grade (adjusted OR=2.54, 95% CI=1.35-4.75, P=0.003).
  
  
  CONCLUSIONS
  We have shown, for the first time, a significant association between metabolic syndrome and impaired myocardial perfusion after percutaneous coronary intervention in patients with acute myocardial infarction. This data may partially explain the poor short and long-term outcomes of acute myocardial infarction in patients with metabolic syndrome.
authors.affiliation: Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey. benturgay@yahoo.com
authors.forename: Turgay
authors.initials: T
authors.lastname: Celik
authors.forename: Hasan
authors.initials: H
authors.lastname: Turhan
authors.forename: Hurkan
authors.initials: H
authors.lastname: Kursaklioglu
authors.forename: Atila
authors.initials: A
authors.lastname: Iyisoy
authors.forename: Uygar Cagdas
authors.initials: UC
authors.lastname: Yuksel
authors.forename: Namik
authors.initials: N
authors.lastname: Ozmen
authors.forename: Ersoy
authors.initials: E
authors.lastname: Isik
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001774:Blood Chemical Analysis; D052279:Creatine Kinase, MB Form / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D010477:Perfusion; D015995:Prevalence; D012044:Regression Analysis
chemical_list: D052279:Creatine Kinase, MB Form