Metabolic syndrome: clinical and angiographic impact on patients with acute coronary syndrome.
BACKGROUND
Metabolic syndrome (MetS) is represented by a cluster of various risk factors and is one of the most important public health problems of the 21st century. The aim of this study was to identify the impact of this syndrome in patients with acute coronary syndrome (ACS).


METHODS
We included patients with ST and non-ST segment elevation ACS. We divided patients into two groups: A) patients with MetS criteria and B) patients without MetS criteria. We compared the incidence of major cardiovascular events, severity of coronary artery disease (CAD), need for urgent revascularization and in-hospital mortality between groups.


RESULTS
Among 917 patients with ACS, 421 (43.4%) fulfilled criteria of MetS. Age of patients in this group was 63.37 +/- 9.95 years (compared with 61.77 +/- 12.20 years in group B), 66.7% vs. 72.8% males, diabetes 70.3% vs. 33.3%, hypertension 87.6% vs. 40.5% and dyslipidemia 70.5% vs. 26.9%, respectively. ST-elevation ACS was more frequent in group A. We observed more severe CAD, and major cardiovascular events were more frequent in group A. Multivariate analysis demonstrated that hyperfibrinogenemia, hyperglycemia and MetS were independent predictors of heart failure and combined end point.


CONCLUSIONS
Incidence of MetS was high in patients with ACS, presented with more comorbidities and older patients, and was associated with poorer in-hospital outcome. It may be probable that the high inflammatory and prothrombotic response and more severe CAD in these patients increase the incidence of major cardiovascular events.
Miller
Alejandra Madrid
AM
Unidad de Cuidados Intensivos Cardiovasculares, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, DF, Mexico. akmadrid@prodigy.net.mx
Alcaraz Ruiz
Antonio
A
Borrayo Sánchez
Gabriela
G
Almeida Gutiérrez
Eduardo
E
Vargas Guzmán
Rosa María
RM
Jáuregui Aguilar
Ricardo
R
D054058:Acute Coronary Syndrome / Q000150:complications*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged