Metabolic syndrome increases mortality in heart failure.
BACKGROUND
Metabolic syndrome (MetS) is a risk factor for diabetes, cardiovascular disease, and heart failure, but little is known about the impact of MetS in patients who already have heart failure (HF).


OBJECTIVE
MetS increases mortality in HF.


METHODS
We performed an analysis in 865 indigent HF patients enrolled in a HF disease management program at the Chabert Medical Center in Louisiana. All subjects were classified as having MetS if they met three or more of the National Cholesterol Education Program criteria. Mortality was defined using the Social Security Death Index. We calculated the relative hazard (RH) of death for those patients with and without MetS.


RESULTS
The prevalence of MetS was 40% (95% confidence interval [CI]: 37-43). These subjects had similar ages (54.3+/-13.4 vs 55.7+/-12.8 years), more likely to be female (43% vs 33%), had similar baseline ejection fraction (31.4+/-9.7 vs 30.0+/-11.0), and New York Heart Association (NYHA) classification (2.20+/-0.9 vs 2.15+/-0.9). After 2.6+/-2.2 years of follow-up 24% of the MetS group died compared to 16% in the non-MetS group (p < 0.01). The RH of death for the MetS group was 1.5 (95% CI: 1.1-2.1) when compared to the non-MetS group after adjustment demographics, use of angiotensin-converting enzyme (ACE) inhibitor and beta-blocker, hematocrit, creatinine, educational level, and baseline ejection fraction.


CONCLUSIONS
The prevalence of MetS is high in indigent HF patients, and it increases the risk of death. Physicians treating patients with HF need to address the current MetS epidemic in HF.
Tamariz
Leonardo
L
Department of Medicine, Miller School of Medicine at the University of Miami, Miami, Florida 33136, USA. ltamariz@med.miami.edu
Hassan
Benjamin
B
Palacio
Ana
A
Arcement
Lee
L
Horswell
Ron
R
Hebert
Kathy
K
D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000401:mortality*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left