Turk Kardiyol Dern Ars. 2007; 35(3): 165-169

The effect of metabolic syndrome on the development of major adverse cardiac events in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction with ST-segment elevation

Tuba Bilsel, Aycan Esen, Vedat Aslan, Gülşah Tayyareci, Öner Engin, Şennur Ünal, Haldun Akgöz
Siyami Ersek Thoracic & Cardiovascular Surgery Training And Research Hospital, İstanbul

OBJECTIVES
This study sought to determine the effect of metabolic syndrome (MS) on the development of major adverse cardiac events (MACE) in the early period of primary coronary intervention (PCI).

STUDY DESIGN
The study included 152 patients (132 males, 20 females; mean age 56.5±11 years) who underwent primary PCI within ≤12 hours of acute myocardial infarction with ST-segment elevation. Patients with diabetes mellitus were excluded. The patients were divided into two groups according to whether they met the NCEP ATP III criteria for MS; hence, 69 patients (45.4%) with MS, and 83 patients (54.6%) without MS (controls). The two groups were compared with respect to clinical and angiographic features, ECG findings, and the development of MACE (death, reinfarction, and repeat vessel revascularization) at one month.

RESULTS
The two groups were similar with respect to culprit arteries and the number of diseased vessels. Initial TIMI flow grade was lower in the MS group compared to controls (p=0.009), but the final TIMI flow grades were similar in both groups (p=0.5). However, patients with MS had a lower rate of ST-segment resolution ≥50% at 90 minutes (p=0.002). At one month follow-up, none of the patients in the control group had MACE, whereas nine patients (13%) in the MS group developed MACE (p=0.001).

CONCLUSION
Patients with MS have a higher risk for developing MACE after primary PCI. Therefore, the presence of MS should be taken into consideration in patients undergoing PCI.

Keywords: Angioplasty, transluminal, percutaneous coronary, metabolic syndrome X/complications; myocardial infarction/ complications; prognosis; risk factors

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