Impact of the Metabolic Syndrome on the Clinical Outcomes of Non-Clinically Diagnosed Diabetic Patients With Acute Coronary Syndrome

Micha S. Feinberg, Roseline Schwartz, David Tanne, Enrique Z. Fisman, Hanoch Hod, Doron Zahger, Ehud Schwammethal, Michael Eldar, Solomon Behar, Alexander Tenenbaum

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

The aim of this study is to explore the impact of metabolic syndrome (MS) on the outcome of patients with non-clinically diagnosed diabetes with acute coronary syndrome (ACS) based on a comprehensive nationwide registry during a 1-year follow-up. In the ACS Israeli Survey, 1,060 consecutive patients with non-clinically diagnosed diabetes were admitted due to ACS; 359 patients with MS features on admission were compared with 701 subjects without MS. A modified National Cholesterol Education Program Adult Treatment Panel III definition of MS was used in patients who presented with ≥3 of the 5 components: (1) hyperglycemia, defined as occasional blood glucose on admission >140 mg/dl; (2) preexisting hypertension; (3) body mass index >28 kg/m2; (4) high-density lipoprotein cholesterol ≤40 mg/dl (men) or ≤50 mg/dl (women); and (5) triglycerides ≥150 mg/dl. Patients with MS were more frequently women (27% vs 12%, p = 0.001), were in Killip ≥II on admission (19% vs 14%, p = 0.03), and had higher 30-day (5.0% vs 1.7%, p = 0.002) and 1-year (8.9% vs 4.6%, p = 0.005) crude mortality rates. Patients with hyperglycemia (glucose >140 mg/dl) and MS had higher 30-day mortality rates compared with patients with hyperglycemia without MS (8.3% vs 2.5%, p <0.05). Multivariate analysis identified MS as a strong independent predictor of 30-day and 1-year mortality with hazard ratios of 2.54 (95% confidence interval 1.22 to 5.31) and 1.96 (95% confidence interval 1.18 to 3.24), respectively. In conclusion, MS defined early at admission is a strong independent predictor of mortality and morbidity in patients with non-clinically diagnosed diabetes with ACS.

Original languageEnglish
Pages (from-to)667-672
Number of pages6
JournalAmerican Journal of Cardiology
Volume99
Issue number5
DOIs
StatePublished - 1 Mar 2007
Externally publishedYes

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