Impact of metabolic syndrome on coronary patency after thrombolytic therapy for acute myocardial infarction

OBJECTIVES: The metabolic syndrome (MS) is highly prevalent in patients with acute myocardial infarction. It has been shown that MS is associated with poor in-hospital outcome and long-term survival in patients with acute myocardial infarction. We aimed to investigate the effect of MS on the infarct-related artery patency in patients treated with thrombolytic therapy for acute myocardial infarction. METHODS: We retrospectively analyzed 116 patients who were admitted to our clinics with acute ST elevation myocardial infarction and received thrombolytic therapy within 12 h of chest pain. MS was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III criteria. The flow in the infarct-related artery was analyzed according to the thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count. RESULTS: MS was present in 55.2% of patients. The proportion of patients with MS who achieved TIMI grade 3 f low after thrombolysis was significantly lower than that of patients without MS (41.5 vs. 58.5%, P < 0.001). Moreover, corrected TIMI frame counts were significantly higher inpatients with MS (58.3+/-34.8 vs. 44.7+/-28.1, P =0.02). On multivariate logistic regression analysis MS was the only independent predictor of TIMI flow less than 3 (P =0.03,odds ratio = 3.545, 95% confidence interval: 1.064-11.808). CONCLUSION: We have shown for the first time that patients with MS have lower rates of TIMI grade 3 flow and higher corrected TIMI frame counts after thrombolytic therapy for acute myocardial infarction.