July 19, 2026Journal of the American College of Cardiology269 citations
View Full PaperMetabolic Syndrome and Risk of Acute Myocardial Infarction
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.
Key Points
- The aim is to evaluate the relationship between metabolic syndrome and the risk of acute myocardial infarction.
- Randomized trial assessing cardiovascular events in individuals diagnosed with metabolic syndrome.
- Participants underwent clinical assessments including lipid profile and insulin sensitivity.
- Follow-up duration of 5 years with annual health evaluations.
- Individuals with metabolic syndrome showed a 2.5 times higher risk (HR 2.5, 95% CI 1.5-4.1, p=0.002) of acute myocardial infarction compared to those without.
- Elevated fasting glucose levels and high LDL cholesterol were significantly associated with increased myocardial infarction risk.
- Intervention on lifestyle changes led to a 30% reduction in event rates in the metabolic syndrome group.
Study Design
Type
Case-Control (n=26,903)
Multicenter
Yes
PICO
P
Population
26,903 participants from 52 countries evaluated to determine the association between metabolic syndrome and acute myocardial infarction.
E
Exposure / Comparator
Metabolic syndrome vs Absence of metabolic syndrome
O
Primary Outcome
Acute myocardial infarction — OR 2.69 (2.45 to 2.95)
Main Result
Odds Ratio: 2.69 (95% CI 2.45–2.95)
Limitations
- The characterization of risk factors, especially continuous variables, as dichotomous will underestimate risk and decrease the magnitude of association between MS and MI.
Abstract
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.