Low rates of exercise in patients with metabolic syndrome after an acute coronary syndrome.

Background: Metabolic syndrome (MetSyn) has reached epidemic proportions; however, regular exercise can prevent its progression to type 2 diabetes.

Hypothesis: The study was undertaken to determine both the rate and predictors of routine exercise 1 year after an acute coronary syndrome (ACS) in patients with MetSyn.

Methods: In a registry of 1,199 patients presenting with ACS, those with MetSyn were identified using the modified NCEP-ATP III criteria. Baseline and 1-year exercise patterns were examined in these patients, and the characteristics of those who were exercising were then compared with those who were not. A multivariable logistic regression analysis was subsequently conducted to identify independent predictors of exercise at 1 year.

Results: Of 273 patients with MetSyn, baseline and 1-year data about patients' exercise patterns were available for 170, of whom only 92 (54.2%) were exercising at 1 year. Characteristics that differed between those who were and those who were not exercising at 1 year included exercise at baseline (40 vs. 16.7%, p<0.001), Caucasian race (92.4 vs. 79.5%, p = 0.01), and body mass index (BMI) (30.4 +/- 4.3 vs. 32.1 +/- 5.0, p = 0.02). In a multivariable analysis, significant independent predictors of exercise were routine exercise at the time of admission for ACS (odds ratio [OR] = 2.6,95% confidence interval [CI] = 1.1-6.4), younger age (OR = 0.67 per 10-year increase [95% CI = 0.45-0.99]), and lower BMI (OR = 0.4 per 10-unit increase [95% CI = 0.17-0.911).

Conclusions: Almost half of patients with MetSyn did not participate in routine exercise 1 year after their admission for ACS. Innovative strategies are needed to increase exercise participation in such patients, particularly those not exercising at baseline as well as obese and older patients.