Predictive value of metabolic syndrome definitions in patients with myocardial infarction with ST segment elevation – are they all the same?

Abstract

Metabolic syndrome according to the NCEP-ATP III definition was associated with increased risk of the development of new cardiovascular events among the patients with STEMI.

In-Hospital Outcomes of Coronary Artery Stenting in Patients With ST-Elevation Myocardial Infarction (STEMI) and Metabolic Syndrome: Insights From the National Inpatient Sample

“…The impact of MetS on mortality outcomes has been inconsistently reported. While the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardio (GISSI)-Prevenzione trial reported an increased risk of all-cause death/mortality in MI patients with MetS [ 20 ], a four-year longitudinal study by Lovic et al in Serbia found no association between MetS and increased mortality among STEMI patients [ 12 ]. In European cohorts of MI patients, MetS was identified as an independent predictor of severe heart failure [ 15 ], MACE [ 11 ], and coronary artery disease (CAD) [ 11 ] but was not associated with in-hospital mortality [ 11 , 15 ].…”

“…However, there is increasing recognition of a phenomenon referred to as the “obesity paradox” wherein better cardiovascular disease (CVD) outcomes are demonstrated in overweight and at least mildly obese patients [ 14 ]. Congruent with these observations, MetS does not seem to increase the risk of all-cause mortality, including in-hospital mortality, among patients with STEMI compared to those without MetS [ 11 , 12 , 15 ].…”

“…The existing literature suggests that metabolic syndrome invariably causes damage to the microcirculation of the heart following direct percutaneous coronary intervention (PCI), ultimately leading to a poor prognosis [ 9 - 11 ]. Consequently, STEMI patients with MetS have an exacerbated risk of major adverse cardiac events (MACEs), especially new revascularization [ 11 , 12 ]. Further, MetS has been associated with an increased occurrence of the no-flow phenomenon among STEMI patients treated with PCI [ 13 ].…”

Relationship between Metabolic Syndrome and Clinical Outcome in Patients Treated with Drug-Eluting Stenting after Rotational Atherectomy for Complex Calcified Coronary Lesions

“…In addition, a systematic review of 55 studies with 162, 450 participants with cardiovascular disease observed a relationship between MS and increased relative risk (RR) for mortality from all causes (RR, 1.220; 95% CI, 1.103–1.349), death from cardiovascular disease (RR, 1.360; 95% CI, 1.152–1.606), MI (RR, 1.460, 95% CI 1.242–1.716), and stroke (RR, 1.435, 95% CI 1.131–1.820) compared with patients without MS [ 35 ]. Many studies have shown that poor outcomes are linked to MS in patients undergoing coronary revascularization [ 31 , 32 , 33 , 36 , 37 , 38 ]. The ten-year rates of cardiovascular events were observed to be elevated in MS patients after coronary artery bypass grafting [ 38 ], while Lovic et al reported an independent association between MS and reduced overall survival in patients with acute MI after coronary stenting [ 31 ].…”

Comparación de diferentes definiciones de síndrome metabólico y su relación con la estimación del riesgo cardiovascular

“…Otros estudios también han encontrado diferencias en el RCV al momento de evaluar distintas definiciones de SM, sin embargo, no utilizaron a la definición de SM de la OMS y en uno de ellos, el evento cardiovascular ya estaba presente. (17,18) Se debe tener en cuenta que estos resultados pueden variar dependiendo de la población o la definición de SM empleada.…”