title: Impact of metabolic syndrome on 10-year clinical outcomes among patients with acute coronary syndrome.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is a risk factor and prognosticator for ischemic heart disease, but its actual effect on long-term mortality after acute coronary syndrome (ACS) remains unknown.
  
  
  RESULTS
  All-cause death and cardiovascular death were investigated among patients with ACS upon admission who underwent complete revascularization by either percutaneous coronary intervention or bypass surgery between 1984 and 1992. MetS was defined according to the NCEP/ATPIII criteria modified for waist circumference. From among 1,836 patients who underwent complete revascularization during the study period, 384 (21.0%) with ACS were enrolled, of whom 163 (42.5%) had MetS. During a mean follow-up of 10.4 +/-3.4 years, the total number of deaths was 83 (21.6%), of which 38 (9.9%) were from cardiovascular causes. Cox proportional hazard analysis revealed that MetS increased the risk of mortality by a ratio of 1.62 (95% confidence interval (CI) 1.01-2.59, P=0.046) and of cardiovascular death by 2.40 (95%CI 1.16-4.94, P=0.018) in patients with ACS.
  
  
  CONCLUSIONS
  MetS is a powerful determinant of long-term all-cause and cardiovascular death after ACS. Furthermore, MetS and ACS might jointly exacerbate poor long-term outcomes.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Kan
authors.initials: K
authors.lastname: Kajimoto
authors.forename: Naozumi
authors.initials: N
authors.lastname: Kubota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kojima
authors.forename: Ken
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology / Q000401:mortality*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000401:mortality*; D008875:Middle Aged; D009204:Myocardial Revascularization; D016016:Proportional Hazards Models; D015996:Survival Rate; D016896:Treatment Outcome