J Korean Med Sci.  2010 Oct;25(10):1456-1461. 10.3346/jkms.2010.25.10.1456.

Impact of the Metabolic Syndrome on the Clinical Outcome of Patients with Acute ST-Elevation Myocardial Infarction

• Lee MG
• Jeong MH
• Ahn Y
• Chae SC
• Hur SH
• Hong TJ
• Kim YJ
• Seong IW
• Chae JK
• Rhew JY
• Chae IH
• Cho MC
• Bae JH
• Rha SW
• Kim CJ
• Choi D
• Jang YS
• Yoon J
• Chung WS
• Cho JG
• Seung KB
• Park SJ

• KMID: 2157849
• DOI: http://doi.org/10.3346/jkms.2010.25.10.1456

Abstract

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.

Keyword

Metabolic Syndrome; Prognosis; Myocardial Infarction

MeSH Terms

Acute Disease
Age Factors
Aged
C-Reactive Protein/analysis
Cholesterol, LDL/blood
Coronary Angiography
Female
Humans
Male
Metabolic Syndrome X/*complications/epidemiology
Middle Aged
Multivariate Analysis
Myocardial Infarction/*complications/mortality/therapy
Predictive Value of Tests
Prognosis
Treatment Outcome
Ventricular Dysfunction, Left/complications/physiopathology

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