Impact of the metabolic syndrome on the clinical outcome of patients with acute ST-elevation myocardial infarction.
We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction Registry, a total of 1,990 patients suffered from acute ST-elevation myocardial infarction (STEMI) between November 2005 and December 2006 were categorized according to the National Cholesterol Education Program-Adult Treatment Panel III criteria of MS. Primary study outcomes included major adverse cardiac events (MACE) during one-year follow-up. Patients were grouped based on existence of MS: group I: MS (n=1,182, 777 men, 62.8±12.3 yr); group II: Non-MS (n=808, 675 men, 64.2±13.1 yr). Group I showed lower left ventricular ejection fraction (LVEF) (P=0.005). There were no differences between two groups in the coronary angiographic findings except for multivessel involvement (P=0.01). The incidence of in-hospital death was higher in group I than in group II (P=0.047), but the rates of composite MACE during one-year clinical follow-up showed no significant differences. Multivariate analysis showed that low LVEF, old age, MS, low high density lipoprotein cholesterol and multivessel involvement were associated with high in-hospital death rate. In conclusion, MS is an important predictor for in-hospital death in patients with STEMI.
Lee
Min Goo
MG
The Heart Center of Chonnam National University Hospital, Gwangju, Korea.
Jeong
Myung Ho
MH
Ahn
Youngkeun
Y
Chae
Shung Chull
SC
Hur
Seung Ho
SH
Hong
Taek Jong
TJ
Kim
Young Jo
YJ
Seong
In Whan
IW
Chae
Jei Keon
JK
Rhew
Jay Young
JY
Chae
In Ho
IH
Cho
Myeong Chan
MC
Bae
Jang Ho
JH
Rha
Seung Woon
SW
Kim
Chong Jin
CJ
Choi
Donghoon
D
Jang
Yang Soo
YS
Yoon
Junghan
J
Chung
Wook Sung
WS
Cho
Jeong Gwan
JG
Seung
Ki Bae
KB
Park
Seung Jung
SJ
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology
D008078:Cholesterol, LDL; D002097:C-Reactive Protein