Impact of metabolic syndrome on coronary patency after  thrombolytic therapy for acute myocardial infarction.
OBJECTIVE
The metabolic syndrome (MS) is highly prevalent in patients with acute myocardial infarction. It has been shown that MS is associated with poor in-hospital outcome and long-term survival in patients with acute myocardial infarction. We aimed to investigate the effect of MS on the infarct-related artery patency in patients treated with thrombolytic therapy for acute myocardial infarction.


METHODS
We retrospectively analyzed 116 patients who were admitted to our clinics with acute ST elevation myocardial infarction and received thrombolytic therapy within 12 h of chest pain. MS was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III criteria. The flow in the infarct-related artery was analyzed according to the thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count.


RESULTS
MS was present in 55.2% of patients. The proportion of patients with MS who achieved TIMI grade 3 f low after thrombolysis was significantly lower than that of patients without MS (41.5 vs. 58.5%, P < 0.001). Moreover, corrected TIMI frame counts were significantly higher inpatients with MS (58.3+/-34.8 vs. 44.7+/-28.1, P =0.02). On multivariate logistic regression analysis MS was the only independent predictor of TIMI flow less than 3 (P =0.03,odds ratio = 3.545, 95% confidence interval: 1.064-11.808).


CONCLUSIONS
We have shown for the first time that patients with MS have lower rates of TIMI grade 3 flow and higher corrected TIMI frame counts after thrombolytic therapy for acute myocardial infarction.
Yasar
Ayse Saatci
AS
Department of Cardiology, Ataturk Education and Research Hospital, Ankara, Turkey. drasaatciyasar@yahoo.com
Bilen
Emine
E
Bilge
Mehmet
M
Arslantas
Ugur
U
Karakas
Fatih
F
D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D003326:Coronary Circulation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016017:Odds Ratio; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013300:Streptokinase / Q000008:administration & dosage; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome; D014654:Vascular Patency
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D013300:Streptokinase; D010959:Tissue Plasminogen Activator