Key result
Metabolic syndrome was associated with an increased risk of acute myocardial infarction using both WHO (OR 2.69; 95% CI 2.45-2.95) and IDF (OR 2.20; 95% CI 2.03-2.38) definitions.
Why the study?
The risk of metabolic syndrome on myocardial infarction has not been well characterized, especially across multiple ethnic groups.
Case-Control (n=26,903)
Yes
Metabolic syndrome may warrant closer MI monitoring; leaves open whether targeted interventions improve outcomes in higher-level trials.
OBJECTIVES: This study examines the risk of acute myocardial infarction (MI) conferred by the metabolic syndrome (MS) and its individual factors in multiple ethnic populations. BACKGROUND: The risk of the MS on MI has not been well characterized, especially in multiple ethnic groups. METHODS: Participants in the INTERHEART study (n = 26,903) involving 52 countries were classified using the World Health Organization (WHO) and International Diabetes Federation (IDF) criteria for MS, and their odds ratios (ORs) for MI were compared with the individual MS component factors. RESULTS: The MS is associated with an increased risk of MI, both using the WHO (OR: 2.69; 95% confidence interval [CI]: 2.45 to 2.95) and IDF (OR: 2.20; 95% CI: 2.03 to 2.38) definitions, with corresponding population attributable risks of 14.5% (95% CI: 12.7% to 16.3%) and 16.8% (95% CI: 14.8% to 18.8%), respectively. The associations are directionally similar across all regions and ethnic groups. Using the WHO definition, the association with MI by the MS is similar to that of diabetes mellitus (OR: 2.72; 95% CI: 2.53 to 2.92) and hypertension (OR: 2.60; 95% CI: 2.46 to 2.76), and significantly stronger than that of the other component risk factors. The clustering of > or =3 risk factors with subthreshold values is associated with an increased risk of MI (OR: 1.50; 95% CI: 1.24 to 1.81) compared with having component factors with "normal" values. The IDF definition showed similar results. CONCLUSIONS: In this large-scale, multi-ethnic, international investigation, the risk of MS on MI is generally comparable to that conferred by some, but not all, of its component risk factors. The characterization of risk factors, especially continuous variables, as dichotomous will underestimate risk and decrease the magnitude of association between MS and MI.
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Mente et al. (2010) conducted a case-control in Acute myocardial infarction (n=26,903). Metabolic syndrome vs. Absence of metabolic syndrome was evaluated on Acute myocardial infarction (OR 2.69, 95% CI 2.45 to 2.95). Metabolic syndrome was associated with an increased risk of acute myocardial infarction using both WHO (OR 2.69; 95% CI 2.45-2.95) and IDF (OR 2.20; 95% CI 2.03-2.38) definitions.
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