Diabetes, Metabolic Syndrome and Obesity (Jul 2021)
Prevalence and Impact of Metabolic Syndrome on Short-Term Prognosis in Patients with Acute Coronary Syndrome: Prospective Cohort Study
Abstract
Korinan Fanta,1 Fekede Bekele Daba,1 Elsah Tegene Asefa,2 Legese Chelkeba,3 Tsegaye Melaku1 1Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia; 2Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia; 3Department of Pharmacology and Clinical Pharmacy, College of Health Science, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Korinan FantaDepartment of Clinical Pharmacy, Institute of Health, Jimma University, P.O.Box: 378, Jimma, EthiopiaTel +251 911598485Fax +251 476617980Email [email protected]: Despite the increasing burden of metabolic syndrome (MS) and ischemic heart disease in sub-Saharan Africa, data on the prevalence of MS among patients with acute coronary syndrome (ACS) from the regions are limited. Hence, this study is aimed to evaluate the prevalence and impact of MS on 30-day all-cause mortality in patients hospitalized with ACS.Patients and Methods: We prospectively assessed 176 ACS patients, who were admitted to two tertiary hospitals in Ethiopia. MS was diagnosed based on a harmonized definition of MS. In-hospital major adverse cardiovascular events (MACE) and 30-day mortality were recorded. Multivariable cox-regression was used to identify predictors of 30-day mortality.Results: Among 176 ACS patients enrolled, 62 (35.2%) had MS. Majority of the patients (62.5%) were male with the mean age of 56± 11.9 years. ACS patients with MS were older, presented with atypical symptoms, and they had history of hypertension, diabetes, dyslipidemia and coronary artery disease compared to those without MS. MS was also significantly associated with in-hospital MACE (30.6% vs 17.5%; p= 0.046) and 30-day mortality [adjusted hazard ratio (AHR) = 3.25, 95% CI=1.72– 6.15]. The other significant predictors of 30-day mortality were pre-hospital delay > 12h (HR= 4.32, 95% CI=1.68– 11.100), killip class ≥ 2 (HR=10.7, 95% CI= 2.54– 44.95), and ejection fraction < 40 (HR= 2.59 95% CI=1.39– 4.84).Conclusion: The prevalence of MS among patients with ACS in Ethiopia is high. MS was significantly associated with high in-hospital MACE and it was an independent predictor of 30-day mortality. Initiating appropriate strategies on MS prevention and timely diagnosis of MS components could decrease the burden of ACS and improve patient’s outcome.Keywords: metabolic syndrome, myocardial infarction, mortality, sub-Saharan Africa
