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Impact of the metabolic syndrome on the clinical outcome of patients with acute ST-elevation myocardial infarction
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
Affiliation:The Heart Center of Chonnam National University Hospital, Gwangju, Korea.
Abstract: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.
Keywords:Metabolic Syndrome   Prognosis   Myocardial Infarction
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