Impact of Metabolic Syndrome and Its Components on Clinical Severity and Long-Term Prognosis in Patients With Premature Myocardial Infarction

Abstract

BackgroundThe effects of metabolic syndrome (MS) on premature myocardial infarction (PMI) are not clear to date. This study aimed to investigate the impact of MS and its components on clinical severity and long-term prognosis in patients with PMI.MethodsWe enrolled 772 patients aged ≤45 years old who were diagnosed with acute myocardial infarction (AMI) at our hospital consecutively between 2015 and 2020. The patients were divided into an MS group and non-MS group. The parameters of clinical severity were compared using regression analysis. Patients were followed for median of 42 months for major adverse cardiovascular events (MACE).ResultsHyperglycemia was associated with multi-vessel disease [odds ratio(OR)=1.700, 95% confidence interval (CI)=1.172-2.464, P=0.005] and Syntax score ≥33 (OR=2.736, 95% CI=1.241-6.032, P=0.013). Increased MACE were observed in the MS group(17.9% vs 10.3%, P=0.004).The Kaplan-Meier curve also showed significant differences (P< 0.001). MS was an independent risk factor for MACE. Of each component of MS, BMI ≥28 kg/m2 (hazard ratio [HR]=2.022, 95% CI =1.213-3.369, P=0.007] and hyperglycemia (HR=2.904, 95% CI=1.847-4.567, P<0.001) were independent risk factors for MACE.ConclusionsIn patients with PMI, 1) hyperglycemia usually indicates more severe lesions; 2) MS as a whole was an independent risk factor for MACE; 3) BMI ≥28.0 kg/m2 and hyperglycemia were associated with MACE.

Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review

“…MetS patients not only are at higher risk of developing myocardial infarction (MI) ( 122 ), but they also tend to have larger infarct size and more in-hospital complications ( 123 ). Of all the different components of MetS, hyperglicemia and BMI ≥28.0 kg/m 2 are associated with major adverse cardiovascular events (MACE) in patients with MI aged <45 year ( 124 ). Moreover, MetS in acute coronary syndrome (ACS) is significantly more present in women (55.9%-66.3%) than in men (40.2%-47.3%) ( 125 , 126 ).…”

Diastolic function and its relationship with the ATP-III criteria for metabolic syndrome in a Latin American cohort

“…To the literature, Obese patients with heart failure have lower concentrations of NT-proBNP due to increased expression of scavenger receptors and increased degradation of the peptides by adipose tissue [14]. It has previously been shown that people with HFpEF and normal NT-proBNP levels had a higher risk of death or rehospitalization from HF compared to people without HF [15]. Clinical studies have shown that patients with HFpEF and low levels of NT-proBNP responded better to mineralocorticoid receptor antagonists and angiotensin receptor blockers compared to patients with higher levels of NT-proBNP [16 -twenty].…”

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.…”