Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The impact of the metabolic syndrome/insulin resistance syndrome (MS/IR S) on the severity and prognosis of acute ST elevation myocardial infarction (STEMI ) treated with primary percutaneous coronary intervention (PCI) was assessed using the American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) definition from 2003. A total of 385 patients having suffered acute STEMI and treated with primary PCI over a two-year period were divided into two groups (with and without MS/IR S) and compared according to the parameters of severity (clinical, laboratory, echocardiography, coronary angiography parameters and complications) and prognosis using major adverse cardiovascular events (MACE) during the six-month follow-up of acute STEMI . In comparison with control group, the MS/IR S group of patients had worse or similar results of almost all study parameters of severity (hospital days 6.5 vs. 6.5, cardiogenic shock 2.9% vs. 2.6%, cardiac arrest 6.8% vs. 5.2%, reinfarction 0.5 vs. 1.6%) and prognosis (total MACE 30.7 vs. 30.7%), however, none of the differences reached statistical significance. It is concluded that the unexpected lack of such differences in MS/IR S could be due to the absence of waist-to-hip ratio in the definition and other open questions in metabolic syndrome in general.Istraživao se utjecaj metaboličnog sindroma/sindroma inzulinske rezistencije (MS/SIR ) koristeći definiciju American Association of Clinical Endocrinologists i American College of Endocrinology (AACE/ACE) iz 2003. na težinu i prognozu akutnog infarkta miokarda s elevacijom ST spojnice (STEMI ) liječenog primarnom perkutanom intervencijom (pPCI). Ukupno 395 bolesnika koji su preboljeli akutni STEMI i bili liječeni pomoću pPCI u dvogodišnjem razdoblju podijeljeno je u dvije skupine (s MS/SIR i bez njih) i uspoređeno prema parametrima težine (klinički, laboratorijski, ehokardiografski, koronarografski, komplikacije) i prognoze koristeći velike neželjene kardiovaskularne događaje (MACE) tijekom šestomjesečnog praćenja akutnog STEMI . Skupina bolesnika s MS/SIR u usporedbi s kontrolnom skupinom imala je uglavnom lošije ili jednake rezultate težine (dani u bolnici 6,5:6,5, kardiogeni šok 2,9%:2,6%, srčani zastoj 6,8%:5,2%, reinfarkt 0,5%:1,6%) i prognoze (ukupno MACE 30,7%:30,7%), no niti jedna od razlika nije dosegla statističku značajnost. Zaključuje se kako bi izostanak takvih očekivanih razlika u MS/SIR mogao biti posljedica isključenja omjera struka i kukova iz ove definicije i ostalih otvorenih pitanja u metaboličnom sindromu uopće
