Metabolic syndrome: influence on clinical severity and prognosis in patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention

Abstract

Objective The aim of this study was to investigate the metabolic syndrome (MS) infl uence on clinical severity and prognosis in patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

Methods We prospectively analysed 250 patients with acute STEMI treated with primary PCI, between September 2011-2012. MS was diagnosed by the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Patients were divided into two groups (with/without MS) and compared by their baseline data (medical history, demographic and anthropometric data) and parameters of severity (clinical, laboratory, echocardiography, coronary angiography and in-hospital complications data) and prognosis (major adverse cardiovascular events and sick leave duration (SLD) during 12 months of follow-up).

Results Our study included 136 (54.4%) and 114 (45.6%) patients with and without MS, respectively. MS patients had longer hospitalization (9.0 vs 8.0 days), higher rates of total in-hospital complications (25.0% vs14.9%), higher number of signifi cantly stenosed coronary arteries (CAs) (2 vs1), higher stent diameters (3.5 vs3.0 mm) ,higher rate of signifi cantly stenosed proximal and middle CAs segments (94.1% vs86.7%), and longer SLD (16 vs10 weeks) (P <0.05). MS was independently associated with higher risk of total in-hospital complications (odds ratio (OR) 1.90, confi dence interval (CI) [1.06-3.64], P= 0.047) and with higher risk of ? 2 signifi cant stenosed CAs (OR 1.72, CI [1.04-2.84], P= 0.034).

Conclusion MS in acute STEMI is an important predictor of total in-hospital complications and severity of CAs disease, but not for other parameters of severity and prognosis. MS patients have longer SLD.

Key Words:

• Metabolic syndrome
• myocardial infarction