S Tudy of Metebolic and Physical Risk Factors in Coronary Artery Disease Patients in GGH Guntur

Abstract

BACKGROUND:Metabolic syndrome is a specific clustering of cardiovascular risk factors, which increases the mortality and morbidity. Hence, we aimed to know the incidence of METS in coronary artery disease proven by coronary angiogram and assess its various components and its impact on the in hospital prognosis of 1 week. METHODS: A total of 100 CAD cases admitted to CCU of Government General Hospital, Guntur were studied over a period of 1 year. Cases were categorized according to the NCEP ATP III METS criteria (presence of ≥3 of the following: hyperglycemia; triglycerides ≥150mg/dl; HDL-C ≤40 mg/dl for males, ≤50mg/dl for females; blood pressure ≥130/85mg/dl; waist Circumference >102 cm in men or >88 cm in women). RESULTS: Among the 100 cases, 44 (44%) fulfilled the criteria for METS and were more likely to be women. Low HDL-C (95%) was the most prevalent component followed by high TGs (95%), hyperglycemia (82%), HT (86%) and high WC (39%). In hospital complications (1week) were higher in METS patients compared to those without and associated with four fold (odds ratio 3.8, p value <0.001) increased risk of complications including heart failure (52%). CONCLUSION: The prevalence of METS was high in coronary artery disease, associated with worse in hospital prognosis of 1week and with four fold higher risk of development of complications including heart failure. KEYWORDS: Metabolic syndrome, Myocardial infarction. INTRODUCTION:Coronary Heart Disease (CHD) has reached enormous proportions striking more and more at younger subjects. It will result in coming years the greatest epidemic mankind has faced; unless we are able to reverse the trend by concentrating on research into its cause and prevention. 1 Coronary Heart disease and its major manifestations were a medical rarity prior to first world war. 2 The prevalence of coronary heart disease is on the raise in our country, more so in South India cutting across all class and age distinctions, imposing severe burden on the health care system. Hence the present study aims to address the reasons for high prevalence of CAD and the risk factors involved, namely the Metabolic Syndrome. 3 Metabolic syndrome refers to constellation of interrelated cardiac risk factors that appear to directly promote development of atherosclerotic cardiovascular disease. 4 A recent review of insulin resistance syndrome revealed a rapid escalation of this syndrome among Indians and the prevalence of predominant component of METS varies from region to region. 5 Studies have revealed the pathophysiology of this syndrome, with close to a six fold increase in cardiovascular mortality in those possessing this disorders. 6 The increased risk of morbidity and mortality associated with the METS makes it essential that there be a clear understanding of the dimensions of this syndrome for the allocation of health care and research resources and for other purposes. 7 Data regarding the prevalence of metabolic syndrome in coronary artery disease from this part of the country is scanty and con...