Impact of the Metabolic Syndrome on the Clinical Outcome of Patients with Acute ST-Elevation Myocardial Infarction

• Published in: Journal of Korean medical science Vol. 25; no. 10; pp. 1456 - 1461
• Main Authors: Lee, Min Goo, Jeong, Myung Ho, Ahn, Youngkeun, Chae, Shung Chull, Hur, Seung Ho, Hong, Taek Jong, Kim, Young Jo, Seong, In Whan, Chae, Jei Keon, Rhew, Jay Young, Chae, In Ho, Cho, Myeong Chan, Bae, Jang Ho, Rha, Seung Woon, Kim, Chong Jin, Choi, Donghoon, Jang, Yang Soo, Yoon, Junghan, Chung, Wook Sung, Cho, Jeong Gwan, Seung, Ki Bae, Park, Seung Jung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.10.2010; 대한의학회
• Subjects: Acute Disease; Age Factors; Aged; C-Reactive Protein - analysis; Cholesterol, LDL - blood; Coronary Angiography; Female; Humans; Male; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Middle Aged; Multivariate Analysis; Myocardial Infarction - complications; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Original; Predictive Value of Tests; Prognosis; Treatment Outcome; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - physiopathology; 의학일반; Myocardial Infarction; Metabolic Syndrome; Prognosis
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2010.25.10.1456

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.