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Am Heart J. 2014 Aug;168(2):182-8.e1. doi: 10.1016/j.ahj.2014.04.009. Epub 2014 Apr 24.

Association of metabolic syndrome and its individual components with outcomes among patients with high-risk non-ST-segment elevation acute coronary syndromes.

Author information

1
Duke Clinical Research Institute, Durham, NC. Electronic address: mehta007@dcri.duke.edu.
2
Canadian VIGOUR Centre at the University of Alberta, Edmonton, Alberta, Canada.
3
Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
4
Department of Medicine, Wilhelminenspital, Vienna, Austria.
5
Centre for Chronic Disease Control, New Delhi, India.
6
Department of Medicine, Stanford University, Stanford, CA.
7
Duke Clinical Research Institute, Durham, NC.

Abstract

BACKGROUND:

The relationship of metabolic syndrome and its individual components (obesity, hypertension, glucose intolerance, high triglycerides, and low high-density lipoprotein cholesterol) with 1-year mortality in non-ST-segment elevation acute coronary syndromes (NSTE ACS) patients is not known.

METHODS:

The association of metabolic syndrome (and its individual components) with all-cause mortality within 1 year was assessed in NSTE ACS patients enrolled in the EARLY ACS trial. Adjusted hazard ratio (HR) and 95% CIs are reported.

RESULTS:

Of 9,406 patients, 2,596 (27.6%) had metabolic syndrome. Compared with those without metabolic syndrome, patients with this syndrome were younger, were more often female, and had a higher prevalence of comorbid conditions and higher-risk presenting features. Metabolic syndrome was not associated with increased 1-year mortality (HR 1.20, 95% CI 0.97-1.47; P = .09). The risk of 1-year mortality varied across the individual components: high-density lipoprotein <40 mg/dL (men)/<50 mg/dL (women; or dyslipidemia) was associated with higher risk (HR 1.52, 95% CI 1.15-2.02), and triglycerides >150 mg/dL (or dyslipidemia) was associated with lower risk (HR 0.66, 95% CI 0.54-0.81), whereas the other components (ie, body mass index >30 kg/m(2), fasting plasma glucose >100 mg/dL or diabetes, systolic blood pressure >130 mm Hg or diastolic >85 mm Hg [or hypertension]) were associated with neutral risk of this event.

CONCLUSIONS:

The individual components of metabolic syndrome had varying associations with 1-year mortality, and as an integrated diagnosis, metabolic syndrome was not significantly associated with 1-year mortality. Thus, patient case-mix of the studied NSTE ACS population may influence the observed relationship of metabolic syndrome with subsequent cardiovascular events.

PMID:
25066557
DOI:
10.1016/j.ahj.2014.04.009
[Indexed for MEDLINE]

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