title: Association of metabolic syndrome and its individual components with outcomes among patients with high-risk non-ST-segment elevation acute coronary syndromes.
abstract: BACKGROUND
  The relationship of metabolic syndrome and its individual components (obesity, hypertension, glucose intolerance, high triglycerides, and low high-density lipoprotein cholesterol) with 1-year mortality in non-ST-segment elevation acute coronary syndromes (NSTE ACS) patients is not known.
  
  
  METHODS
  The association of metabolic syndrome (and its individual components) with all-cause mortality within 1 year was assessed in NSTE ACS patients enrolled in the EARLY ACS trial. Adjusted hazard ratio (HR) and 95% CIs are reported.
  
  
  RESULTS
  Of 9,406 patients, 2,596 (27.6%) had metabolic syndrome. Compared with those without metabolic syndrome, patients with this syndrome were younger, were more often female, and had a higher prevalence of comorbid conditions and higher-risk presenting features. Metabolic syndrome was not associated with increased 1-year mortality (HR 1.20, 95% CI 0.97-1.47; P = .09). The risk of 1-year mortality varied across the individual components: high-density lipoprotein <40 mg/dL (men)/<50 mg/dL (women; or dyslipidemia) was associated with higher risk (HR 1.52, 95% CI 1.15-2.02), and triglycerides >150 mg/dL (or dyslipidemia) was associated with lower risk (HR 0.66, 95% CI 0.54-0.81), whereas the other components (ie, body mass index >30 kg/m(2), fasting plasma glucose >100 mg/dL or diabetes, systolic blood pressure >130 mm Hg or diastolic >85 mm Hg [or hypertension]) were associated with neutral risk of this event.
  
  
  CONCLUSIONS
  The individual components of metabolic syndrome had varying associations with 1-year mortality, and as an integrated diagnosis, metabolic syndrome was not significantly associated with 1-year mortality. Thus, patient case-mix of the studied NSTE ACS population may influence the observed relationship of metabolic syndrome with subsequent cardiovascular events.
authors: Duke Clinical Research Institute, Durham, NC. Electronic address: mehta007@dcri.duke.edu.
authors: Rajendra H
authors: RH
authors: Mehta
authors: Canadian VIGOUR Centre at the University of Alberta, Edmonton, Alberta, Canada.
authors: Cynthia M
authors: CM
authors: Westerhout
authors: Canadian VIGOUR Centre at the University of Alberta, Edmonton, Alberta, Canada.
authors: Yinggan
authors: Y
authors: Zheng
authors: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors: Robert P
authors: RP
authors: Giugliano
authors: Department of Medicine, Wilhelminenspital, Vienna, Austria.
authors: Kurt
authors: K
authors: Huber
authors: Centre for Chronic Disease Control, New Delhi, India.
authors: Dorairaj
authors: D
authors: Prabhakaran
authors: Department of Medicine, Stanford University, Stanford, CA.
authors: Robert A
authors: RA
authors: Harrington
authors: Duke Clinical Research Institute, Durham, NC.
authors: Kristin L
authors: KL
authors: Newby
authors: Canadian VIGOUR Centre at the University of Alberta, Edmonton, Alberta, Canada.
authors: Paul W
authors: PW
authors: Armstrong
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality*; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D020379:Risk Adjustment; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose