Babić Zdravko, Pavlov Marin, Bulj Nikola, Heitzler Vjeran Nikolić, Mitrović Veselin, Hamm Christian, Weber Michael
Department of Cardiology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Acta Clin Croat. 2011 Jun;50(2):193-9.
The impact of the metabolic syndrome/insulin resistance syndrome (MS/IRS) on the severity and prognosis of acute ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) was assessed using the American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) definition from 2003. A total of 385 patients having suffered acute STEMI and treated with primary PCI over a two-year period were divided into two groups (with and without MS/IRS) and compared according to the parameters of severity (clinical, laboratory, echocardiography, coronary angiography parameters and complications) and prognosis using major adverse cardiovascular events (MACE) during the six-month follow-up of acute STEMI. In comparison with control group, the MS/IRS group of patients had worse or similar results of almost all study parameters of severity (hospital days 6.5 versus 6.5, cardiogenic shock 2.9% versus 2.6%, cardiac arrest 6.8% versus 5.2%, reinfarction 0.5 versus 1.6%) and prognosis (total MACE 30.7 versus 30.7%), however, none of the differences reached statistical significance. It is concluded that the unexpected lack of such differences in MS/IRS could be due to the absence ofwaist-to-hip ratio in the definition and other open questions in metabolic syndrome in general.
采用美国临床内分泌医师协会和美国内分泌学会（AACE/ACE）2003年的定义，评估代谢综合征/胰岛素抵抗综合征（MS/IRS）对接受直接经皮冠状动脉介入治疗（PCI）的急性ST段抬高型心肌梗死（STEMI）严重程度及预后的影响。在两年时间里，共有385例急性STEMI患者接受了直接PCI治疗，这些患者被分为两组（有和无MS/IRS），并根据严重程度参数（临床、实验室、超声心动图、冠状动脉造影参数及并发症）以及急性STEMI六个月随访期间使用主要不良心血管事件（MACE）评估的预后进行比较。与对照组相比，MS/IRS组患者几乎所有严重程度研究参数（住院天数6.5天对6.5天，心源性休克2.9%对2.6%，心脏骤停6.8%对5.2%，再梗死0.5对1.6%）及预后（总MACE 30.7对30.7%）的结果更差或相似，然而，这些差异均未达到统计学意义。得出的结论是，MS/IRS中出现这种意外差异缺乏可能是由于定义中没有腰臀比以及代谢综合征中其他未解决的问题。
