Chonnam National University Hospital, Gwangju, Korea.
Korean Circ J. 2013 Aug;43(8):519-26. doi: 10.4070/kcj.2013.43.8.519. Epub 2013 Aug 31.
Metabolic syndrome (MetS) is an important risk factor for cardiovascular disease. However, the clinical outcome of acute myocardial infarction (AMI) with MetS has not been well examined. The purpose of this study was to evaluate the clinical outcomes of AMI patients with MetS.
We evaluated a total of 6352 AMI patients who had successful percutaneous coronary interventions and could be identified for MetS between 2005 and 2008 at 51 hospitals participating in the Korea Acute Myocardial Infarction Registry. They were divided into 2 groups according to the presence of MetS: the MetS group (n=2493, 39.2%) versus the Non-MetS group (n=3859, 60.8%). In addition, 4049 AMI patients with high levels of low density lipoprotein-cholesterol (LDL-C) (≥100 mg/dL) among them, were divided into the MetS group (n=1561, 38.6%) versus the Non-MetS group (n=2488, 61.4%).
In the overall population, there was no significant difference in 12-month the major adverse cardiac events (MACE) rate between the 2 groups. However, the MetS group showed a significantly higher 12-month MACE rate in the high LDL-C population. Multivariate analysis showed that MetS was an independent prognostic factor for 12-month MACE {hazard ratio (HR) 1.607, 95% confidence interval (CI) 1.027 to 2.513, adjusted p=0.038} and for 12-month target vessel revascularization (HR 1.564, 95% CI 1.092 to 2.240, adjusted p=0.015) in the high LDL-C population.
MetS patients with AMI in the overall population showed no significant difference in 12-month clinical outcomes. However, in patients with higher LDL-C ≥100 mg/dL, they showed significantly worse clinical outcome than Non-MetS patients. Therefore, it is important to ascertain the presence of MetS in AMI patients, and more aggressive therapy should be strongly considered for AMI patient with MetS.
代谢综合征（MetS）是心血管疾病的重要危险因素。然而，代谢综合征合并急性心肌梗死（AMI）的临床转归尚未得到充分研究。本研究旨在评估 MetS 合并 AMI 患者的临床结局。
我们评估了 2005 年至 2008 年期间，在参与韩国急性心肌梗死注册研究的 51 家医院中，6352 例接受成功经皮冠状动脉介入治疗且可诊断为 MetS 的 AMI 患者。根据是否存在 MetS，将其分为两组：MetS 组（n=2493，39.2%）和非 MetS 组（n=3859，60.8%）。此外，在其中的 4049 例 LDL-C 水平升高（≥100mg/dL）的 AMI 患者中，MetS 组（n=1561，38.6%）和非 MetS 组（n=2488，61.4%）。
在总体人群中，两组 12 个月主要不良心脏事件（MACE）发生率无显著差异。然而，在 LDL-C 水平升高的人群中，MetS 组的 12 个月 MACE 发生率显著更高。多变量分析显示，MetS 是 12 个月 MACE 的独立预后因素[危险比（HR）1.607，95%置信区间（CI）1.027 至 2.513，调整后 p=0.038]和 12 个月靶血管血运重建（HR 1.564，95%CI 1.092 至 2.240，调整后 p=0.015）的独立预后因素。
在总体人群中，合并 AMI 的 MetS 患者 12 个月临床结局无显著差异。然而，在 LDL-C 水平更高（≥100mg/dL）的患者中，其临床结局明显差于非 MetS 患者。因此，在 AMI 患者中确定 MetS 的存在很重要，对于合并 MetS 的 AMI 患者，应强烈考虑更积极的治疗。
