Impact of metabolic syndrome on 10-year clinical outcomes among patients with acute coronary syndrome.

BACKGROUND Metabolic syndrome (MetS) is a risk factor and prognosticator for ischemic heart disease, but its actual effect on long-term mortality after acute coronary syndrome (ACS) remains unknown. METHODS AND RESULTS All-cause death and cardiovascular death were investigated among patients with ACS upon admission who underwent complete revascularization by either percutaneous coronary intervention or bypass surgery between 1984 and 1992. MetS was defined according to the NCEP/ATPIII criteria modified for waist circumference. From among 1,836 patients who underwent complete revascularization during the study period, 384 (21.0%) with ACS were enrolled, of whom 163 (42.5%) had MetS. During a mean follow-up of 10.4 +/-3.4 years, the total number of deaths was 83 (21.6%), of which 38 (9.9%) were from cardiovascular causes. Cox proportional hazard analysis revealed that MetS increased the risk of mortality by a ratio of 1.62 (95% confidence interval (CI) 1.01-2.59, P=0.046) and of cardiovascular death by 2.40 (95%CI 1.16-4.94, P=0.018) in patients with ACS. CONCLUSIONS MetS is a powerful determinant of long-term all-cause and cardiovascular death after ACS. Furthermore, MetS and ACS might jointly exacerbate poor long-term outcomes.