Prevalence and Impact of Metabolic Syndrome on Short-Term Prognosis in Patients with Acute Coronary Syndrome: Prospective Cohort Study

Abstract

Purpose: Despite the increasing burden of metabolic syndrome (MS) and ischemic heart disease in sub-Saharan Africa, data on the prevalence of MS among patients with acute coronary syndrome (ACS) from the regions are limited. Hence, this study is aimed to evaluate the prevalence and impact of MS on 30-day all-cause mortality in patients hospitalized with ACS. Patients and Methods: We prospectively assessed 176 ACS patients, who were admitted to two tertiary hospitals in Ethiopia. MS was diagnosed based on a harmonized definition of MS. In-hospital major adverse cardiovascular events (MACE) and 30-day mortality were recorded. Multivariable cox-regression was used to identify predictors of 30-day mortality. Results: Among 176 ACS patients enrolled, 62 (35.2%) had MS. Majority of the patients (62.5%) were male with the mean age of 56±11.9 years. ACS patients with MS were older, presented with atypical symptoms, and they had history of hypertension, diabetes, dyslipidemia and coronary artery disease compared to those without MS. MS was also significantly associated with in-hospital MACE (30.6% vs 17.5%; p= 0.046) and 30-day mortality [adjusted hazard ratio (AHR) = 3.25, 95% CI=1.72-6.15]. The other significant predictors of 30-day mortality were pre-hospital delay >12h (HR= 4.32, 95% CI=1.68-11.100), killip class ≥2 (HR=10.7, 95% CI= 2.54-44.95), and ejection fraction <40 (HR= 2.59 95% CI=1.39-4.84). Conclusion:The prevalence of MS among patients with ACS in Ethiopia is high. MS was significantly associated with high in-hospital MACE and it was an independent predictor of 30-day mortality. Initiating appropriate strategies on MS prevention and timely diagnosis of MS components could decrease the burden of ACS and improve patient's outcome.

Association of Metabolic Syndrome With Long-Term Cardiovascular Risks and All-Cause Mortality in Elderly Patients With Obstructive Sleep Apnea

“…The growing burden of obesity, sedentary lifestyles, and dietary patterns has led to an increase in the prevalence of MetS. Further, it has been associated with a higher risk of MACE when compared with general population (11). Our group has previously shown a longitudinal association between type 2 diabetes and MACE, hospitalization for unstable angina, and a composite of all events in elderly patients with OSA (12).…”

Association of Thyroid Hormones Level with Coronary Lesion Complexity in Patients with Acute Coronary Syndrome

“…Short-term and long-term mortality of individuals suffering from acute coronary syndrome (ACS) remains high despite advancements in medication and myocardial reperfusion methods (1) .…”

“…Short-term and long-term mortality of individuals suffering from acute coronary syndrome (ACS) remains high despite advancements in medication and myocardial reperfusion methods (1) . including high-sensitivity troponin, natriuretic peptides, and C-reactive protein (CRP) give added predictive value (1) .…”

Impact of metabolic syndrome on clinical characteristics and one-year outcomes of patients undergoing primary percutaneous coronary intervention

“…Similarly, in other studies, men have always been more than women, so in the studies of Fanta et al 62.5% in the study of Babic et al 70.3% and the study of Arbel et al 72.5% of the study population were men. In general, the incidence of coronary artery disease in women is lower due to the presence of the sex hormones estrogen and progesterone, which modulate the lipid pro le (12)(13)(14). Although the majority of patients were men, this percentage was signi cantly different in the two groups with MetS and non-MetS, and the percentage of female patients in the MetS group was higher than in the non-metabolic group (29.2-4.6%).…”