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Little information is available regarding the clinical effect of metabolic syndrome (MS) or its combined effect with smoking on subsequent cardiac events after acute myocardial infarction (AMI). To examine whether MS independently predicts cardiac events (cardiac death and nonfatal reinfarction) and to assess the combined effect of MS and smoking on cardiac events after AMI, we studied 3,858 survivors of AMI registered in the Osaka Acute Coronary Insufficiency Study (OACIS). During a median follow-up of 725 days, the incidence of cardiac events was higher in patients with MS than in those without MS (p=0.

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