Key result
Metabolic syndrome fails to increase 1-year MACE in acute STEMI despite higher in-hospital mortality.
Why the study?
The prevalence of metabolic syndrome in patients with acute STEMI and its effect on clinical outcomes were not well defined.
Does metabolic syndrome increase the risk of adverse clinical outcomes in patients with acute ST-elevation myocardial infarction?
Observational (n=1,990)
Yes
Does metabolic syndrome increase the risk of adverse clinical outcomes in patients with acute ST-elevation myocardial infarction?
Absolute Event Rate: 21% vs 19.1%
p-value: p=0.33
Metabolic syndrome is an important predictor for in-hospital death in patients with STEMI, although it does not significantly affect one-year MACE rates.
Metabolic syndrome may warrant closer in-hospital monitoring in STEMI; leaves open its influence on 1-year MACE or targeted interventions.
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.
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Lee et al. (2010) conducted an observational in Acute ST-elevation myocardial infarction (STEMI) (n=1,990). Metabolic Syndrome vs. No Metabolic Syndrome was evaluated on Composite major adverse cardiac events (MACE) at 12 months (p=0.33). In patients with acute STEMI, metabolic syndrome was an independent predictor of in-hospital death (OR 2.65) but did not significantly increase the rate of composite major adverse cardiac events at 1 year (21.0% vs 19.1%).
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