Prognostic Value of Metabolic Syndrome in Patients With Non-ST Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Abstract

ObjectiveWe aim to investigate the prognostic effects of metabolic syndrome (MS) on patients with non-ST elevated myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI).MethodsPatients with NSTEMI undergoing PCI were consecutively collected. According to the presence or absence of MS, they were divided into two groups and followed up for 1 year. The endpoint was major adverse cardiovascular events (MACE), including all-cause death, unstable angina hospitalization, heart failure (HF) hospitalization, non-fatal recurrent myocardial infarction (MI), and target lesion revascularization. Also, six subgroups were made according to gender, age, left ventricular ejection fraction (LVEF), Global Registry of Acute Coronary Events (GRACE) score, hypersensitive troponin (hsTNT), and several diseased vessels. Cox proportional hazard model was adopted to analyze the effect of MS on MACE in all the patients and different subgroups.ResultsA total of 1,295 patients were included in the current analysis and 660 (50.97%) of them had MS. About 88 patients were lost to follow-up, and the overall average follow-up was 315 days. MS was an independent risk factor for MACE (HR 1.714, CI 1.265–2.322, p = 0.001), all-cause death, heart failure (HF) hospitalization, and non-fatal recurrent MI. In the MS component, BMI ≥28 kg/m2 was positively associated with MACE. Subgroup analysis indicated the prognostic value of MS was more striking for patients with the following: age of >60, LVEF of ≤40%, GRACE of >140, multivessel disease, or hsTNT of >0.1 ng/ml.ConclusionsThe MS was a robust adverse prognostic factor in patients diagnosed with NSTEMI, especially among those of older age and at higher ischemic risk. A BMI of ≥28 kg/m2 independently predicted the occurrence of MACE. Prognosis may be improved by controlling abdominal obesity.

Prevalence and impact of metabolic syndrome on in-hospital outcomes in patients with acute myocardial infarction: A perspective from a developing country

“…[9,19–22] In Taiwan, Li-Hong Zhao et al (2022) reported a prevalence of MetS of 50.9%. [13] Similarly, Lee et al reported a 59.40% prevalence of ST-elevation AMI in South Korea. [23] These findings suggest that MetS is a common occurrence in the population of coronary artery disease patients, particularly among those with AMI.…”

“…[10,11] Until around 20 years ago, the prevalence of MetS in Asian countries was low compared with that in Western countries. [12,13] A comprehensive meta-analysis of 87 studies involving 951,083 patients demonstrated that MetS is associated with a 2-fold increase in cardiovascular mortality, AMI, and stroke, and a 1.5-fold increase in all-cause mortality risk. [14] Most of these studies were carried out in developed countries among patients with ACS who were managed differently, and this likely affected their prognosis and the likelihood of new adverse outcomes.…”

Correlation Between Different Parameters of Acute Myocardial Infarction and Obesity

“…Similar observations were reported in Non-ST-elevation myocardial infarction, where patients with a BMI of ≥28 kg/m 2 had a more adverse outcome and the occurrence of MACE. It was concluded that controlling abdominal obesity might improve the prognosis [15].…”

Influence of Metabolic Syndrome on the Long-Term Prognosis of Patients with Myocardial Infarction: A Meta-Analysis

“…1. Consequently, the meta-analysis included 10 observational studies [19][20][21][22][23][24][25][26][27][28].…”

“…These studies were performed in Italy, Japan, Korea, Serbia, and China, and published between 2005 and 2022. As for study design, five studies were prospective cohort studies [21,23,25,27,28], four were retrospective cohort [20,22,24,26], and another one was post-hoc analysis of a clinical trial [19]. All the studies included patients with MI (total sample size: 33 197), with mean age of the patients varying from 41 to 71 years.…”