Metabolic syndrome is associated with extension of coronary artery disease in patients with non-ST segment elevation acute coronary syndromes
Yuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Sihhiye, Turkey. Coronary Artery Disease
(Impact Factor: 1.5).
09/2005; 16(5):287-92. DOI: 10.1097/00019501-200508000-00005
Metabolic syndrome (MS) comprises a group of factors that are associated with increased risk for cardiovascular events. Acute coronary syndromes account for the most important part of cardiovascular events with considerable morbidity and mortality. We aimed to investigate the association of MS with extension of coronary artery disease in patients presenting with non-ST segment elevation (NSTE) acute coronary syndromes (ACS).
Three hundred and six consecutive patients (220 men, 86 women patients) with the diagnosis of NSTE ACS, who were hospitalized within the first 24 h of their chest pain in the coronary care unit, were prospectively enrolled into our study. Patients with elevation of troponins (T or I) were classified as NSTE myocardial infarction (MI) and otherwise as unstable angina pectoris (USAP). Components of MS were noted as previously identified. Coronary angiograms were evaluated by two authors, who were blinded to the study plan and each other, via Sullivan's method.
MS was noted in 49% of all patients, and was significantly more common in women than in men (62.8 versus 43.6%, P=0.003). The mean total stenosis score of patients with MS was significantly higher than for those without MS (16+/-6 versus 12+/-5, P<0.001), and the mean extension score of patients with MS was significantly higher than for those without MS (63+/-29 versus 44+/-26, P<0.001). The presence of MS together with some clinical factors and poor total cholesterol/high-density lipoprotein cholesterol ratio, hypertension and diabetes mellitus, was found to be independently predictive of extension of coronary artery disease (CAD) in a group of patients presenting with NSTE ACS.
MS is independently associated with CAD extension, and hence, might account for poor cardiovascular outcomes through CAD extension in patients with NSTE ACS.
Available from: Rafid Fayadh Al-Aqeedi
- "For the purpose of easier analysis, non-ST elevation MI (NSTEMI) and unstable angina (UA) were grouped together in a common group and labeled NSTE Acute Coronary Syndrome (NSTE-ACS), as opposed to ST-elevation MI (STEMI). This has been used by several recent studies (14, 15). "
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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).
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.
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.
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.
Available from: tcyh.yds.edu.vn
Available from: tcyh.yds.edu.vn
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ABSTRACT: Muïc tieâu nghieân cöùu: Xaùc ñònh taàn suaát hoäi chöùng chuyeån hoùa ôû beänh nhaân beänh ñoäng maïch vaønh. Phöông phaùp nghieân cöùu: Moâ taû, tieàn cöùu. Khaûo saùt caùc thaønh phaàn cuûa hoäi chöùng chuyeån hoùa (taêng huyeát aùp, ñaùi thaùo ñöôøng, taêng voøng eo, taêng triglyceride, vaø giaûm HDL) ôû beänh nhaân beänh ñoäng maïch vaønh ñöôïc chaån ñoaùn baèng chuïp ñoäng maïch vaønh caûn quang. Keát quaû: 205 beänh nhaân coù sang thöông gaây heïp >50% ñöôøng kính loøng ñoäng maïch vaønh (qua chuïp ñoäng maïch vaønh caûn quang) ñöôïc ñöa vaøo nghieân cöùu. Taàn suaát hoäi chöùng chuyeån hoùa ôû nhoùm beänh nhaân naøy laø 46,83%, taäp trung cao nhaát ôû löùa tuoåi 50 - 59 vaø ôû phaùi nöõ nhieàu hôn phaùi nam. Hoäi chöùng chuyeån hoùa hieän dieän cao nhaát ôû beänh nhaân ñaùi thaùo ñöôøng (83,61%), keá ñeán laø ôû beänh nhaân coù BMI >25 (67,44%) vaø sau ñoù laø ôû beänh nhaân taêng huyeát aùp (55,41%). Keát luaän: Beänh nhaân beänh ñoäng maïch vaønh trong nghieân cöùu naøy coù taàn suaát maéc hoäi chöùng chuyeån hoùa cao, taäp trung nhieàu ôû phaùi nöõ, ôû beänh nhaân ñaùi thaùo ñöôøng, beänh nhaân coù BMI cao vaø beänh nhaân taêng huyeát aùp. SUMMARY
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