Background Metabolic syndrome (MS) is a well known risk factor for cardiovascular disease. But, scarce data exists about the demographic, laboratory, clinical and angiographic differences in Korean patients with acute myocardial infarction (AMI) having MS. We aimed to assess the baseline characteristics, clinical presentation and short-term prognosis in AMI patients with or without MS.
Methods 230 patients hospitalized with AMI from Jan. 2005 to Dec. 2007 (195 STEMI and 35 NSTEMI, 170 males) were categorized MS or not according to NCEP-ATP III metabolic syndrome criteria.
Results The incidence of MS was higher in female than male (53.5% vs. 32.9%, p=0.008). The baseline profiles of the patients with MS were similar to non-MS patients in age (61.3짹13.3 vs. 60.6짹13.3 yrs), Killip class, pre and post PCI TIMI grade. The patients with MS showed higher weight (67.6짹12.6 vs. 62.7짹10.9 Kg, p=0.001), BMI (25.4짹4.3 vs. 23.2짹3.0 Kg/m2, p=0.001), waist circumference (92.5짹7.3 vs. 84.1짹10.6 cm, p=0.001), initial WBC (12054짹3659 vs. 11103짹3832/uL, p=0.06), uric acid (5.4짹1.8 vs. 4.7짹1.5 mg/dL, p=0.002), and lower HDL-cholesterol level at hospitalization (39.4짹9.1 vs. 46.8짹9.7 mg/dL, p<0.0001) , 6 months after discharge (39.6짹9.3 vs. 45.8짹10.6 mg/dL, p=0.0003) compared with non-MS patients. Poor ABI (1.06짹0.15 vs. 1.11짹0.11, p=0.03) was noted in MS patients. The incidene of major adverse clinical events (MACE) including all cause of death, non-fatal stroke, non-fatal MI, stent thrombosis and target lesion revascularization during hospitalization (5.75% vs. 7.09%, p=0.90) and 6 months after discharge (5.41% vs. 7.38, p=0.80) was comparable.
Conclusion In patients with AMI, the prevalence of MS was high especially in female. MS is associated with worse clinical variables, e.g. higher BMI, waist circumference, poor lipid profile and ABI. Especially uric acid and HDL-C which are well-known prognostic factors in cardiovascular disease was drastic in MS group. With limited number and single center experience, we can't foretell the siginificance of MS in AMI. Therefore, the national registry of AMI for evaluating siginficance of MS should be considered.