Metabolic syndrome and risk of acute coronary syndromes in patients younger than 45 years of age.
OBJECTIVE
There is a paucity of data with regard to the association of the metabolic syndrome with cardiovascular risk in young adults. We investigated the association of the metabolic syndrome with acute coronary syndrome in adults aged 45 years or younger.


METHODS
A total of 136 consecutive patients (128 men and eight women; mean age, 41.2+/-3.7 years) presenting with a first-ever acute coronary syndrome, and 136 age-matched and sex-matched controls were evaluated. The diagnosis of the metabolic syndrome was established according to the Adult Treatment Panel III criteria.


RESULTS
The prevalence of the metabolic syndrome was significantly higher in the patients' group compared with the control group (40.4 versus 23.5%; P=0.003). Multivariate logistic regression analysis showed that smoking, positive family history of premature coronary artery disease, and the metabolic syndrome were associated with odds ratios 4.46 (95% confidence interval, 2.30-8.66; P<0.001), 3.11 (95% confidence interval, 1.71-5.66; P<0.001), and 1.97 (95% confidence interval, 1.08-3.56; P=0.02) higher odds, respectively, of having an acute coronary syndrome, after taking into account the matching for age and sex and controlling for potential confounders. Moreover, a 10-mg/dl increase in total cholesterol was associated with 1.06 higher odds of having an acute coronary syndrome. Analysis of interaction showed that smoking and a positive family history of premature coronary artery disease in young individuals with metabolic syndrome had an incremental effect on the odds of suffering an acute coronary syndrome (odds ratio, 7.12; 95% confidence interval, 2.42-20.96; P<0.001).


CONCLUSIONS
The metabolic syndrome is highly associated with acute coronary syndrome in patients younger than 45 years of age, indicating the need for early and intensive preventive measures.
Milionis
Haralampos J
HJ
Department of Internal Medicine, School of Medicine, University of Ioannina, Greece. hmilioni@cc.uoi.gr
Kalantzi
Kallirroi J
KJ
Papathanasiou
Athanasios J
AJ
Kosovitsas
Athanasios A
AA
Doumas
Michael T
MT
Goudevenos
John A
JA
D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D015995:Prevalence; D013577:Syndrome