Metabolic syndrome: influence on clinical severity and prognosis in patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.

Objective: The aim of this study was to investigate the metabolic syndrome (MS) influence on clinical severity and prognosis in patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

Methods: We prospectively analysed 250 patients with acute STEMI treated with primary PCI, between September 2011-2012. MS was diagnosed by the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Patients were divided into two groups (with/without MS) and compared by their baseline data (medical history, demographic and anthropometric data) and parameters of severity (clinical, laboratory, echocardiography, coronary angiography and in-hospital complications data) and prognosis (major adverse cardiovascular events and sick leave duration (SLD) during 12 months offollow-up). Results Our study included 136 (54.4%) and 114 (45.6%) patients with and without MS, respectively. MS patients had longer hospitalization (9.0 vs 8.0 days), higher rates of total in-hospital complications (25.0% vs 14.9%), higher number of significantly stenosed coronary arteries (CAs) (2 vs 1), higher stent diameters (3.5 vs 3.0 mm), higher rate of significantly stenosed proximal and middle CAs segments (94.1% vs 86.7%), and longer SLD (16 vs 10 weeks) (P < 0.05). MS was independently associated with higher risk of total in-hospital complications (odds ratio (OR) 1.90, confidence interval (CI) [1.06-3.64], P = 0.047) and with higher risk of > or =2 significant stenosed CAs (OR 1.72, Cl [1.04-2.84], P= 0.034).

Conclusion: MS in acute STEMI is an important predictor of total in-hospital complications and severity of CAs disease, but not for other parameters of severity and prognosis. MS patients have longer SLD.