Metabolic syndrome and long-term cardiovascular outcomes in NSTEMI with unstable angina.
OBJECTIVE
Metabolic syndrome (MS) is associated with cardiovascular mortality and morbidity in patients with acute coronary syndrome. The purpose of this study was to evaluate the impact of MS on long-term clinical outcomes in patients with pure non-ST segment myocardial infarction (NSTEMI) or unstable angina pectoris (USAP).


RESULTS
We prospectively enrolled 310 consecutive NSTEMI/USAP patients (74 females; mean age, 59.3 ± 11.9 years). The study population was divided into two groups: MS(+) and MS(-). The clinical outcomes of the patients were followed for up to 3 years. Increased 3-year cardiovascular mortality and reinfarction were observed in the MS(+) group, as compared to the MS(-) group (15 vs. 3.4%, p = 0.001, and 22.2 vs. 8.3%, p = 0.001, respectively). Hospitalization rates for heart failure and stroke were not significantly different between the two groups on follow-up. By a Cox multivariate analysis, a significant association was noted between MS and the adjusted risk of 3-year cardiovascular mortality (odds ratio 3.4, 95% confidence interval, 1.24-9.1, p = 0.02).


CONCLUSIONS
These results suggest that MS is associated with an increased risk of 3-year cardiovascular mortality and reinfarction in patients with NSTEMI/USAP.
Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey. Electronic address: doktorseref@hotmail.com.
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Kul
Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
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Uyarel
Department of Cardiology, Mehmet Akif Ersoy Thoracic-Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
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Gul
Department of Emergency, Faculty Of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
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Kucukdaglı
Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
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Bacaksiz
Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
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Erdogan
Department of Cardiology, Siyami Ersek Thoracic-Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
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Ekmekci
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000150:complications / Q000401:mortality* / Q000473:pathology; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000401:mortality* / Q000473:pathology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000002:abnormalities* / Q000473:pathology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000145:classification / Q000401:mortality; D009765:Obesity / Q000097:blood / Q000150:complications / Q000401:mortality; D016017:Odds Ratio; D011446:Prospective Studies; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D055815:Young Adult
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides
Acute coronary syndrome; Cardiovascular mortality; Metabolic syndrome; Reinfarction