Metabolie syndrome and cardiovascular risk factors in patients with a first coronary event

Abstract

Background: coronary heart disease is the main cause of death in people older than 45 years in the world. There are no massive programs of primary prevention directed to high-risk patients. The Adult Treatment Panel (ATP) III recommends as first step the assessment of the absolute risk of a major cardiovascular event at ten years and as a second step the identification of persons with metabolic syndrome as candidates for intensified therapeutic lifestyle changes.

Aim: to establish the prevalence of metabolic syndrome and cardiovascular risk factors in patients with acute coronary syndrome. To evaluate Framingham scale in this population.

Design: prospective longitudinal descriptive study.

Methods: patients with acute coronary syndrome from February to November 2001 were included. The prevalence of metabolic syndrome and the frequency of the risk factors were established according to the ATP III criteria. We used the Framingham scoring and ILIB categories to evaluate the 10-year absolute risk of a major cardiovascular event.

Results: one hundred-fifty-five patients were studied; 112 (72.3%) were male, with an average of 57.6 years old (SD 10.4 years); 129 patients (83.2%) were admitted with the diagnosis of myocardial infarction and 26 (16.8%) with unstable angina. Metabolic syndrome was found in 51 patients (32.9%). The frequency of the major risk factors was: hypertension 91 (58.7%), hypercholesterolemia 79 (51%), smoking 41 (26.5%), diabetes mellitus 33 (21.3%), and familiar coronary disease 38 (26.5%). We registered a high frequency of emerging risk factors: sedentarism 110 (71%), low cHDL 103 (66.5%), high tryglicerides 66 (42.6%) abdominal obesity 62 (40%), overweight 67 (43.2%), and obesity 21 (13.5%). According to the Framingham scale and the ILIB categories, the majority of patients were in latent and intermediate risk and only one third were classified as high risk (34.2%).

Conclusions: one third of the patients with acute coronary syndrome had metabolic syndrome. There was a high frequency of major and emerging risk factors. Only one third part of the patients were classified as a high risk (>20%) according to the Framingham's scoring and ILIB categories.