The prevalence of the metabolic syndrome components and their combinations in men and women with acute ischemic syndromes

Abstract

During the last decade, it has been shown that the metabolic syndrome and its different components – arterial hypertension (AH), abdominal obesity (AO), diabetes mellitus (DM), atherogenic hypertriglyceridemia (HTG), and/or low concentration of high-density lipoprotein cholesterol (HDL-C)) – increase the risk of cardiovascular diseases. There is increasing evidence that the incidence of the metabolic syndrome and the distribution of its components in combinations in the general male and female population differ. The aim of our study was to determine the incidence of the metabolic syndrome in men and women with acute ischemic syndromes and to evaluate the distribution of the metabolic syndrome component combinations in the presence of the metabolic syndrome. Contingent and methods. The study included 2756 patients (1670 males and 1086 females) with acute ischemic syndromes (1997 with myocardial infarction and 759 with unstable angina pectoris), in whom all five components of the metabolic syndrome were assessed. Women were significantly older than men (68.1±9.5 vs. 60.2±11.8 years, P<0.001). The metabolic syndrome was found (according to modified NCEP III) in 1641 (59.5%) patients (in 70.2% of females and in 52.6% of males, P<0.001). The most common components in both men and women were AH andAO(94.0%vs. 95.9%and 86.4%vs. 84.5%, respectively). HTGwas significantlymore common in men than in women (80.0% vs. 73.0%, P<0.001), while decreased HDL-C concentration was more common in women (82.8% and 59.2%, P<0.001). The DM component, detected in more than one-third of patients with acute ischemic syndromes, was significantly more common in women than in men (39.2% vs. 33.1%, P<0.05). Combinations of three components were significantly more common in men than in women, while combinations of four–five components were more common in women (55.6% vs. 41.4%, P<0.001; and 58.6% vs. 44.4%, P<0.01). The most common combination of three components in men was AH+AO+HTG and in women – AH+AO+lowHDL-C; themost common combination of four components in bothmen and women was AH+AO+HTG+low HDL-C. Conclusion. In the metabolic syndrome, the differences between the components of atherogenic dyslipidemia in patients with acute ischemic syndromes were related to the patients’ gender: men significantly more frequently had increased TG concentration and women – decreased HDLC concentration; this is the problem to be addressed in further studies of dyslipidemia.

Metabolic syndrome influencing infarct size and heart failure in patients with acute coronary syndrome — does gender matter?

“…Similar to some previous studies, the incidence of MetS was high [19,40], around 60%. MetS was associated with a higher rate of cardiac failure following ACS, while so far there are data about higher rates of heart failure following myocardial infarction [21] (in the present study patients with unstable angina were not involved).…”

“…Among 230 patients with ACS 141 (61.3%) met criteria for MetS according to WHO (similar to data from literature [19]), while 89 (38.7%) did not have MetS. MetS was present in 92 of 152 male patients (60.5%) and in 49 of 78 females (62.8%), so there were no significant differences in gender.…”

“…There are some data about the incidence of MetS in patients with acute myocardial infarction [19], as well as that MetS predisposes to higher rate of complications like cardiac failure, myocardial reinfarction [20,21], and according to some authors also to sudden cardiac death [20,21]. Some authors state that the presence of MetS even in nondiabetic patients with myocardial infarction predisposes to larger myocardial size and a higher rate of acute renal failure [22].…”

“…Regarding age there are some data that patients with MetS having myocardial infarction are older [21], while regarding gender women may have significantly higher rate of MetS during acute coronary syndrome (ACS) than men, and might be significantly older than men having ACS [19]. 2) Laboratory parameters: peak serum levels of cardiac enzymes [CK, (CK-MB fraction expressed in IU/mL)], that were checked every 8 h until peak and descent was documented.…”

Gender Differences in the Epidemiology, Clinical Presentation, Prevention, and Prognosis of Acute Coronary Syndromes

“…22 Raised TG levels were more frequent in men (80.0% vs 73.0%, P < .001), whereas dysglycemia and low HDL-C levels were found in women (82.8% vs 59.2% and 39.2% vs 33.1%, P < .05, respectively). 22 In contrast, among 100 patients with CHD, the prevalence of MetS was slightly greater in men than in women (32% vs 28%, respectively). 23 The highest prevalence of MetS was noted in patients with ST-elevation myocardial infarction (odds ratio 3.39, 95% confidence intervals 1.36-8.41).…”