Key result
Metabolic syndrome affects ~69% of non-diabetic men hospitalized with acute coronary syndrome.
Why the study?
Cardiovascular mortality in the Middle East is projected to increase substantially, but data on the prevalence of metabolic syndrome and its components in non-diabetic patients presenting with ACS in this region were limited.
What is the prevalence of metabolic syndrome and its individual components in male patients admitted with acute coronary syndrome without a previous diagnosis of diabetes mellitus?
Cross-Sectional (n=467)
No
What is the prevalence of metabolic syndrome and its individual components in male patients admitted with acute coronary syndrome without a previous diagnosis of diabetes mellitus?
Demonstrates a very high prevalence (69.4%) of metabolic syndrome among non-diabetic Middle Eastern men presenting with acute coronary syndrome, highlighting the urgent need for population-level screening and lifestyle interventions.
High prevalence supports screening consideration in non-diabetic male ACS; leaves open whether intervention improves outcomes.
BACKGROUND: Mortality from cardiovascular disease in the Middle East is projected to increase substantially in the coming decades. The prevalence of metabolic syndrome (MS) in acute coronary syndrome (ACS) continues to raise interest, but data from the Middle East is limited, especially in non-diabetic patients. This study was conducted to ascertain the prevalence of MS and frequency of its components, individually and in combination, in a male population presenting with ACS, but without a previous diagnosis of diabetes mellitus (DM). METHODS: This is a prospective study of 467 consecutive male patients hospitalized for ACS. They were categorized according to the specific criteria stated in the latest joint statement for the global definition of MS. RESULTS: The mean age was (49.7±10.7 years). Of the 467 patients, 324 (69.4%) fulfilled the criteria for MS. ST-Elevation Myocardial Infarction (STEMI) was identified in 178 patients (54.9%), and non-ST elevation ACS (NSTE-ACS) in 146 patients (45.1%). These proportions were not significantly different from those without MS (STEMI 51.7% vs. NSTE-ACS 48.3%, respectively). However, patients with MS were older (50.6±10 vs. 47.9±11 years; p=0.012), and more than half of those with MS were above 50 years. The most common abnormal metabolic components were reduced high-density lipoprotein cholesterol (HDL-c; 94.1%), elevated fasting blood glucose (FBG; 89.8%), and elevated triglycerides (81.8%), followed by increased waist circumference (61.7%) and raised blood pressure (40.4%). The majority of patients with MS had three or more metabolic components (326 patients, 69.4%), and 102 (21.8%) had two components, but only 37 (8.4%) had a single component. CONCLUSIONS: In ACS patients, without previous history of DM, MS is highly prevalent. Reduced HDL, elevated FBG and triglycerides were the most frequent metabolic components. The majority had multiple components. These findings raise alarm and show that drug therapy alone may not be fully effective, unless the underlying risk factors causing MS, such as weight and exercise, are also tackled.
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Al-Aqeedi et al. (2013) conducted a cross-sectional in Acute coronary syndrome without prior diagnosis of diabetes mellitus (n=467). Metabolic syndrome (per joint international criteria) vs. Patients without metabolic syndrome was evaluated on Prevalence of metabolic syndrome. Metabolic syndrome was present in 69.4% of non-diabetic male patients admitted with acute coronary syndrome, with reduced HDL-c (94.1%) and elevated fasting glucose (89.8%) being most frequent.
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