title: Metabolic syndrome predicts lower functional recovery in female but not in male patients after an acute cardiac event.
abstract: OBJECTIVE
  To evaluate whether metabolic syndrome MS has a gender dependent effect on the recovery of functional capacity in patients (pts) with coronary heart disease (CHD) undergoing a cardiac rehabilitation program.
  
  
  RESULTS
  We studied 286 CHD patients, age 66.2+/-10.6 (median+/-SD); M/F 187/99. Patients were divided into two groups according to the presence (MS, 48%) or not (nMS, 52%) of MS. MS was present in 48% of patients. Functional capacity was assessed by the distance walked at six minute walking test (6MWT), and by a maximal exercise test. Compared to patients without MS, those with MS walked a lower distance at 6MWT (438+/-110 vs 408+/-123 m; p<0.05), had a lower maximal exercise capacity (7.6+/-1.8 vs 9.3+/-1.2 MET; p<0.05) and a lower heart rate recovery (HRR) (16+/-9 vs 22+/-8; p<0.05). Male patients with or without MS had a similar degree of functional recovery (51%) while women with MS had a significantly lower recovery than nMS (20% vs 40%). In a multivariate logistic regression model, including body mass index, age, gender hypertension, ejection fraction and diabetes, MS predicted a reduced performance at 6MWT in the overall population (OR 1.4, 95% CI 1.7 to 2.4) and in women (OR 1.31; 95% CI 1.20-1.62), while it was not predictive in males.
  
  
  CONCLUSIONS
  CAD patients with MS have lower functional recovery and HRR than nMS. However MS is an independent predictor of lower exercise capacity only in female gender.
authors.affiliation: Centre for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele Roma, Roma, Italy. giuseppe.caminiti@sanraffaele.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caminiti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Volterrani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marazzi
authors.forename: Rosalba
authors.initials: R
authors.lastname: Massaro
authors.forename: Cristiana
authors.initials: C
authors.lastname: Vitale
authors.forename: Lucia
authors.initials: L
authors.lastname: Gatta
authors.forename: Caterina
authors.initials: C
authors.lastname: Mammi
authors.forename: Marco
authors.initials: M
authors.lastname: Miceli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rosano
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000503:physiopathology* / Q000534:rehabilitation*; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology* / Q000534:rehabilitation*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012727:Sex Characteristics