Prevalence of metabolic syndrome in patients with premature coronary artery disease proven by coronary angiogram
DOI:
https://doi.org/10.18203/2320-6012.ijrms20174963Keywords:
Coronary angiogram, Coronary artery disease, Metabolic syndrome, Young patientsAbstract
Background: Metabolic syndrome (MS) is associated with premature coronary artery disease (CAD). The aim of this study was to evaluate the prevalence of MS and its association with severity of CAD proven by coronary angiogram (CAG) in young patients.
Methods: We included patients, aged 45 years or less, admitted with acute coronary syndrome (ACS), who had CAD confirmed by coronary angiography. They were divided into two groups according to the presence or absence of MS based on International Diabetes Federation (IDF) criteria. CAD was classified into single, double and triple vessel disease (TVD). The prevalence of MS and its individual parameters was calculated.
Results: Among 90 young patients who presented with ACS, MS was present in 67 patients (74.44%). Among those with MS, the prevalence of each individual criterion was statistically significant in MS group (P <0.05). Prevalence of pre-existing hypertension and diabetes was significantly higher in MS group (p <0.01). Smoking, alcohol consumption and family history of CAD were not statistically significant in patients with and without MS. Fifteen out of 90 patients (14 in MS group) who presented with ACS had TVD in CAG, but this was not statistically significant (p 0.06).
Conclusions: This study confirms a very high prevalence of MS in young Indian patients with premature CAD. MS was more prevalent than the conventional risk factor smoking in young CAD patients. We could not find significant difference in severity of CAD based on CAG between MS and non-MS group.
References
De Backer GG. The global burden of coronary heart disease. Medicographia. 2009;31(4):343-8.
Gupta R, Gupta VP, Sarna M, Bhatnagar S, Thanvi J, Sharma V, et al. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Ind heart J. 2002;54(1):59-66.
Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The lancet. 2004;364(9438):937-52.
Alberti KG, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. The Lancet. 2005;366(9491):1059-62.
Reddy KK, Rao AP, Reddy TP. Socioeconomic status and the prevalence of coronary heart disease risk factors. Asia Pac J Clin Nutr. 2002;11(2):98–103.
Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. Metabolic syndrome and the cardiovascular risk a systematic review and metaanalysis. J Am Coll Cardio. 2010; 56(14):1113-32.
Iribarren C, Go AS, Husson G, Sidney S, Fair JM, Quertermous T, et al. Metabolic syndrome and earlyonset coronary artery disease: is the whole greater than its parts?. J Am Coll Cardiol 2006;48(9):1800-7.
Danciu SC, Iqbal FM, Manankil MF, Koul S, Raghuvir R, Herrera CJ. Metabolic Syndrome in Younger Patients with Acute Coronary Syndrome. Eur J Gen Med. 2012;91(1):22-6.
Hassanin N, Gharib S, El Ramly MZ, Meged MA, Makram A. Metabolic syndrome and coronary artery disease in young Egyptians presenting with acute coronary syndrome. Kasr Al Ainy Medic J. 2015;21(1):27.
Aggarwal A, Aggarwal S, Sharma V. Metabolic syndrome and coronary artery disease in Indians younger than 40 years. J Endo Meta. 2012;2(1):39-45.
Das UN. Metabolic syndrome X is common in South Asians, but why and how? Nutrition. 2002;18:774–6.
Das UN. Pathobiology of metabolic syndrome X in obese and nonobese South Asian Indians: further discussion and some suggestions. Nutrition 2003;19:560–2.
Ranjith N, Pegoraro RJ, Naidoo DP, Esterhuizen TM. Metabolic syndrome in young Asian Indian patients with myocardial infarction: cardiovascular topic. Cardio J Afr. 2007;18(4):228-32.
Turhan H, Yasar AS, Basar N, Bicer A, Erbay AR, Yetkin E. High prevalence of metabolic syndrome among young women with premature coronary artery disease. Coron Artery Dis. 2005;16(1):37-40.
Marroquin OC, Kip KE, Kelley DE, Johnson BD, Shaw LJ, Bairey Merz CN, et al. Metabolic syndrome modifies the cardiovascular risk associated with angiographic coronary artery disease in women: a report from the Women’s Ischemia Syndrome Evaluation. Circulation. 2004;109(6):714-21.
Von Eyben FE, Bech J, Madsen JK, Efsen F. High prevalence of smoking in young patients with acute myocardial infarction. J R Soc Health 1996;116(3):153-6.
Sadeghian S, Darvish S, Salimi S, Esfehani FA, Fallah N, Mahmoodian M, et al. Metabolic syndrome: stronger association with coronary artery disease in young men in comparison with higher prevalence in young women. Coron Artery Dis. 2007;18(3):163-8.
Goswami B, Tayal D, Tyagi S, Mallika V. Prevalence of metabolic syndrome in patients with angiographically proven coronary artery disease presenting to a tertiary care hospital in Delhi, India. Diabetes Meta Synd. 2011;5(2):53-60.
Watson KE, Ansell BJ, Watson AD, Fonarow GC. HDL function as a target of lipid-modifying therapy. Rev Cardiovasc Med. 2007;8(1):1–8.
Raji A, Seely EW, Arky RA, Simonson DC. Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J Cl Endocrinol Meta. 2001; 86(11):5366-71.
Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al. INTERHEART Study Investigators. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005;366(9497):1640 –9.
Jayasinghe SR, Jayasinghe SH. Variant metabolic risk factor profile leading to premature coronary disease: time to define the syndrome of accelerated athero-coronary metabolic syndrome in Asian Indians. Singapore Med J. 2009;50(10):949–55.
Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA. 2007;297(3):286–94.
Chung EH, Curran PJ, Sivasankaran S, Chauhan MS, Gossman DE, Pyne CT, et al. Prevalence of Metabolic Syndrome in Patients < 45 Years of Age with Acute Myocardial Infarction Having Percutaneous Coronary Intervention. Am J Cardio. 2007;100(7):1052-5.
