Horm Metab Res 2024; 56(06): 435-444
DOI: 10.1055/a-2196-3764
Original Article: Endocrine Care

Influence of Metabolic Syndrome on the Long-Term Prognosis of Patients with Myocardial Infarction: A Meta-Analysis

Tianfeng Chen
1   Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
,
Zhewei Shi
1   Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
,
Caizhen Qian
1   Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
› Author Affiliations
Fundings Zhejiang Provincial Medical and Health Science and Technology Project — 2021KY1165 Shaoxing Science and Technology Plan Project — 2020A13084 Zhejiang Provincial Medical and Health Science and Technology Project — 2020KY337

Abstract

The influence of metabolic syndrome (MetS) on long-term prognosis of patients with myocardial infarction (MI), the most severe type of coronary artery disease, remains not fully determined. This systematic review and meta-analysis were conducted to investigate the association between MetS and long-term clinical outcomes of patients with MI. A systematic search of Medline, Web of Science, and Embase databases from inception to June 25, 2023, was conducted to obtain eligible studies. Only studies with follow-up duration for at least one year were considered. A random-effects model was utilized to pool the results, accounting for heterogeneity. Ten observational studies were included, which included 33 197 patients with MI. Among them, 17 244 (51.9%) were with MetS at baseline. During a follow-up duration of 12 to 48 months (mean: 22.5 months), patients with MetS were associated with higher incidence of major adverse cardiovascular events [risk ratio (RR): 1.35. 95% confidence interval (CI): 1.19 to 1.54, p<0.001; I2=64%] and all-cause deaths (RR: 1.34, 95% CI: 1.18 to 1.52, p<0.001; I2=23%), as compared to those without MetS at baseline. Subgroup analyses showed that the results were not significantly affected by study characteristics such as study country, design, type of MI, mean age of the patients, treatment with percutaneous coronary intervention, follow-up durations, or study quality scores (p for subgroup difference all>0.05). In patients with MI, MetS may be a risk factor of poor long-term prognosis.



Publication History

Received: 30 August 2023

Accepted after revision: 17 October 2023

Article published online:
06 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Tsao CW, Aday AW, Almarzooq ZI. et al. Heart disease and stroke statistics-2023 update: a report From the American heart association. Circulation 2023; 147: e93-e621
  • 2 Khan MA, Hashim MJ, Mustafa H. et al. Global epidemiology of ischemic heart disease: results from the Global Burden of Disease Study. Cureus 2020; 12: e9349
  • 3 Ozaki Y, Hara H, Onuma Y. et al. CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) update 2022. Cardiovasc Interv Ther 2022; 37: 1-34
  • 4 Bahit MC, Kochar A, Granger CB. Post-myocardial infarction heart failure. JACC Heart Fail 2018; 6: 179-186
  • 5 Oristrell G, Ribera A. Evolution of the prognosis of acute myocardial infarction. Med Clin (Barc). 2023. 160. 118-120
  • 6 Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365: 1415-1428
  • 7 Ambroselli D, Masciulli F, Romano E. et al. New advances in metabolic syndrome, from prevention to treatment: the role of diet and food. Nutrients 2023; 15: 640
  • 8 Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep 2018; 20: 12
  • 9 Mottillo S, Filion KB, Genest J. et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010; 56: 1113-1132
  • 10 Grandl G, Wolfrum C. Hemostasis, endothelial stress, inflammation, and the metabolic syndrome. Semin Immunopathol 2018; 40: 215-224
  • 11 Roberts CK, Hevener AL, Barnard RJ. Metabolic syndrome and insulin resistance: underlying causes and modification by exercise training. Compr Physiol 2013; 3: 1-58
  • 12 Masenga SK, Kabwe LS, Chakulya M. et al. Mechanisms of oxidative stress in metabolic syndrome. Int J Mol Sci 2023; 24: 7898
  • 13 Li X, Zhai Y, Zhao J. et al. Impact of metabolic syndrome and its components on prognosis in patients with cardiovascular diseases: a meta-analysis. Front Cardiovasc Med 2021; 8: 704145
  • 14 Su Y, Zhang X. Association of metabolic syndrome with adverse outcomes in patients with stable coronary artery disease: a meta-analysis. Horm Metab Res 2023; 55: 96-102
  • 15 Hasebe T, Hasebe N. Impact of risk factors related to metabolic syndrome on acute myocardial infarction in younger patients. Hypertens Res 2022; 45: 1447-1458
  • 16 Higgins J, Thomas J, Chandler J. et al. Cochrane handbook for systematic reviews of interventions version 6.2. The Cochrane Collaboration. 2021 www.training.cochrane.org/handbook
  • 17 Page MJ, Moher D, Bossuyt PM. et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372: n160
  • 18 Wells GA, Shea B, O'Connell D. et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2010 http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
  • 19 Levantesi G, Macchia A, Marfisi R. et al. Metabolic syndrome and risk of cardiovascular events after myocardial infarction. J Am Coll Cardiol 2005; 46: 277-283
  • 20 Takeno M, Yasuda S, Otsuka Y. et al. Impact of metabolic syndrome on the long-term survival of patients with acute myocardial infarction: potential association with C-reactive protein. Circ J 2008; 72: 415-419
  • 21 Hoshida S, Teragaki M, Lim YJ. et al. Admission with metabolic disorder is a useful predictor of the 1-year prognosis for patients with unstable angina, but not for patients with acute myocardial infarction: east-Osaka acute coronary syndrome registry. Coron Artery Dis 2011; 22: 416-420
  • 22 Kim CS, Choi JS, Bae EH. et al. Association of metabolic syndrome and renal insufficiency with clinical outcome in acute myocardial infarction. Metabolism 2013; 62: 669-676
  • 23 Kim I, Kim MC, Sim DS. et al. Effect of the metabolic syndrome on outcomes in patients aged<50 years versus>50 years with acute myocardial infarction. Am J Cardiol 2018; 122: 192-198
  • 24 Lee SH, Jeong MH, Kim JH. et al. Influence of obesity and metabolic syndrome on clinical outcomes of ST-segment elevation myocardial infarction in men undergoing primary percutaneous coronary intervention. J Cardiol 2018; 72: 328-334
  • 25 Lovic MB, Savic L, Matic D. et al. Predictive value of metabolic syndrome definitions in patients with myocardial infarction with ST segment elevation – are they all the same?. Acta Cardiol 2018; 73: 574-582
  • 26 Abdu FA, Mohammed AQ, Liu L. et al. Metabolic syndrome and the risk of adverse cardiovascular events in patients with myocardial infarction with non-obstructive coronary arteries. Nutr Metab Cardiovasc Dis 2022; 32: 666-674
  • 27 Gao J, Wang Y, Yang YN. et al. Impact of metabolic syndrome and its components on clinical severity and long-term prognosis in patients with premature myocardial infarction. Front Endocrinol (Lausanne) 2022; 13: 920470
  • 28 Zhao LH, Liu Y, Xiao JY. et al. Prognostic value of metabolic syndrome in patients with non-ST elevated myocardial infarction undergoing percutaneous coronary intervention. Front Cardiovasc Med 2022; 9: 912999
  • 29 Yang Y, Shen H, Jin Z. et al. Association between metabolic syndrome and all-cause mortality in patients with acute coronary syndrome: a meta-analysis. Horm Metab Res 2021; 53: 257-263
  • 30 Kragelund C, Hassager C, Hildebrandt P. et al. Impact of obesity on long-term prognosis following acute myocardial infarction. Int J Cardiol 2005; 98: 123-131
  • 31 Upur H, Li JL, Zou XG. et al. Short and long-term prognosis of admission hyperglycemia in patients with and without diabetes after acute myocardial infarction: a retrospective cohort study. Cardiovasc Diabetol 2022; 21: 114
  • 32 Cui CY, Zhou MG, Cheng LC. et al. Admission hyperglycemia as an independent predictor of long-term prognosis in acute myocardial infarction patients without diabetes: a retrospective study. J Diabetes Investig 2021; 12: 1244-1251
  • 33 Suzuki K, Oikawa T, Nochioka K. et al. Elevated serum non-HDL (high-density lipoprotein) cholesterol and triglyceride levels as residual risks for myocardial infarction recurrence under statin treatment. Arterioscler Thromb Vasc Biol 2019; 39: 934-944
  • 34 Chen G, Hemmelgarn B, Alhaider S. et al. Meta-analysis of adverse cardiovascular outcomes associated with antecedent hypertension after myocardial infarction. Am J Cardiol 2009; 104: 141-147
  • 35 Jin L, Cai S, Qian J. et al. Poor recovery of cardiac function in myocardial infarction patients with metabolic syndrome and microalbuminuria. Herz 2021; 46: 135-140
  • 36 Bari MA, Islam MS, Paul GK. et al. Metabolic syndrome is a risk factor for development of heart failure in acute myocardial infarction. Mymensingh Med J 2012; 21: 633-638
  • 37 Ostadal P, Steg PG, Poulouin Y. et al. Metabolic risk factors and effect of alirocumab on cardiovascular events after acute coronary syndrome: a post-hoc analysis of the ODYSSEY OUTCOMES randomised controlled trial. Lancet Diabetes Endocrinol 2022; 10: 330-340