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

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....

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Veröffentlicht in:The American heart journal 2014-08, Vol.168 (2), p.182-188.e1
Hauptverfasser: Mehta, Rajendra H., MD, MS, Westerhout, Cynthia M., PhD, Zheng, Yinggan, MA, MEd, Giugliano, Robert P., MD, Huber, Kurt, MD, PhD, Prabhakaran, Dorairaj, MD, Harrington, Robert A., MD, Newby, Kristin L., MD, Armstrong, Paul W., MD
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Sprache:eng
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Zusammenfassung: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 30 kg/m2 , 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.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2014.04.009