DOI: http://dx.doi.org/10.18203/2349-3933.ijam20200077

Assessment of incidence rate and prognosis of metabolic syndrome among acute myocardial infarction: a longitudinal study

Archana M. Uppin, Raju H. Badiger, Gayatri Sharma, Rishab Soni, Sowmya Parne, Pavan Kumar Maddiri

Abstract


Background: The Metabolic Syndrome (METS) is a specific clustering of cardiovascular risk factors in the same person (abdominal obesity, atherogenic dyslipidemia, elevated Blood Pressure (BP), Insulin Resistance (IR), and a proinflammatory state. A recent review of insulin resistance syndrome revealed a rapid escalation of this syndrome among Indians and the prevalence of predominant component of METS varies from region to region. Hence the present study was undertaken to assess the incidence of Metabolic Syndrome and prognosis of metabolic syndrome among acute myocardial infarction patients.

Methods: A longitudinal study was carried among Acute myocardial infarction patients, who were admitted to ICCU of Shri. B. M. Patil Hospital and Research Centre, Bijapur during November 2009 to March 2011. Sample size was calculated using the formula: n=4pq/L2. Sample size required was 92. Descriptive statistics and Inferential statistics were used to analyse the results.

Results: The incidence rate of METS among AMI in our study was 48.7%.  The complications were more common in METS group compared to those without METS groups. Recovery was better among those without METS group. There was a statistically significant association between complications and status of METS. The past history of DM was more common in METS. Hyperglycemia among the components of METS has strongest association with the outcome of death in patients of AMI.

Conclusions: The metabolic syndrome is a highly prevalent condition among the patients with acute myocardial infarction and has detrimental impact on outcome Metabolic syndrome is also associated with a higher risk of severe heart failure and death.


Keywords


Acute myocardial infarction, Blood pressure, Cardiovascular diseases, Diabetes mellitus, Heart failure, Metabolic syndrome

Full Text:

PDF

References


Third report of the National Cholesterol Education Program (NCEP) Expert panel on Detection, Evaluation, and Treatment of high blood cholesterol in adults (Adult Treatment Panel III) Final report. Circulation. 2002;106:3146-421.

Yajnik CS. The insulin resistance epidemic in India: fetal origins, later lifestyle, or both?. Nutrit Rev. 2001;59(1):1-9.

Stamler J. Established major coronary risk factors: historical overview. Marmot M. Elliot P. Eds. Coronary heart disease epidemiology: from aetiology to public health. 2005;2:18-31.

Ford ES, Giles WH. A comparison of the prevalence of the metabolic syndrome using two proposed definitions. Diabet Care. 2003;26(3):575-81.

Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. Jama. 2002;287(3):356-9.

Ramachandran A, Snehalatha C, Satyavani K, Sivasankari S, Vijay V. Metabolic syndrome in urban Asian Indian adults-a population study using modified ATP III criteria. Diabet Res Clin Pract. 2003;60(3):199-204.

Gupta A, Gupta R, Sarna M, Rastogi S, Gupta VP, Kothari K. Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabet Res Clin Pract. 2003;61(1):69-76.

Deepa R, Shanthirani CS, Premalatha G, Sastry NG, Mohan V. Prevalence of insulin resistance syndrome in a selected south Indian population--the Chennai urban population study-7 [CUPS-7]. Ind J Med Res. 2002;115:118-27.

Cameron AJ, Shaw JE, Zimmet PZ. The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metabol Clin. 2004;33(2):351-75.

Gogia A, Agarwal PK. Metabolic syndrome. Ind J Med Sci. 2006;60(2).

Mohan V, Shanthirani S, Deepa R, Premalatha G, Sastry NG, Saroja R. Intra‐urban differences in the prevalence of the metabolic syndrome in southern India-the Chennai Urban Population Study (CUPS No. 4). Diabe Med. 2001;18(4):280-7.

Deepa M, Farooq S, Datta M, Deepa R, Mohan V. Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES‐34). Diabetes/metabol Res Rev. 2007;23(2):127-34.

Misra A, Misra R, Wijesuriya M, Banerjee D. The metabolic syndrome in South Asians: continuing escalation & possible solutions. Ind J Med Res. 2007;125(3):345.

Munjal YP, Sarena A. Metabolic syndrome: Assessing Cardiometabolic risk, Chapter 50: In YP Munjal, Post-graduate medicine (Recent Advances in Medicine): JP Publishers: 2007;461.

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabe Care. 1998 Sep 1;21(9):1414-31.

Milani RV, Lavie CJ. Prevalence and profile of metabolic syndrome in patients following acute coronary events and effects of therapeutic lifestyle change with cardiac rehabilitation. Am J Cardiol. 2003;92(1):50-4.

Ninomiya JK, L’Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulat. 2004;109(1):42-6.

Levantesi G, Macchia A, Marfisi R, Franzosi MG, Maggioni AP, Nicolosi GL, et al. Metabolic syndrome and risk of cardiovascular events after myocardial infarction. J Am College Cardiol. 2005;46(2):277-83.

Zeller M, Gabriel P, Ravisy J, Laurent Y, Manifican LJ, Hullier, et al. Prevalence and impact of metabolic syndrome on hospital outcomes in acute myocardial infarction. Arch Intern Med. 2005;165(10):1192-8.

Schwartz GG, Olsson AG, Szarek M, Sasiela WJ. Relation of characteristics of metabolic syndrome to short-term prognosis and effects of intensive statin therapy after acute coronary syndrome: an analysis of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial. Diabe Care. 2005;28(10):2508-13.

Deedwania PC. Metabolic syndrome and vascular disease: is nature or nurture leading the new epidemic of cardiovascular disease?. Circulat. 2004;109(1):2-4.

Aronson D, Rayfield EJ, Chesebro JH. Mechanisms determining course and outcome of diabetic patients who have had acute myocardial infarction. Annal Inter Med. 1997;126(4):296-306.

Munja YP. Metabolic syndrome-A useful concept. Chapter-32 in: RK Singal. Medicine update: Jaypee Publishers. 2007;17:185-9.