Impact of Metabolic Syndrome on In-Hospital Outcomes in Patients with Acute Coronary Syndrome in Previously Non-Cardiac Population - Iman Study

Abstract

Objectives: This study aimed to evaluate the impact of metabolic syndrome (MetS) on in-hospital outcomes in patients presenting with their first episode of acute coronary syndrome (ACS). Methodology: This descriptive cross-sectional study was conducted on 128 patients meeting the inclusion criteria. After obtaining approval from the Ethical Review Committee of CMAT&RH and informed consent, detailed demographic and medical history data, including age and gender, were collected. The presence of MetS was assessed through clinical examination of waist circumference and blood pressure, along with laboratory tests for fasting blood glucose and lipid profile. In-hospital outcomes were recorded, and all data were documented in a structured questionnaire for analysis. Results: Among the 128 participants, 103 were diagnosed with MetS. The mean age was 57±8 years. The study population consisted of 65 females and 63 males, with a male-to-female ratio of 0.97. The mean blood pressure was 129±14/79±10 mmHg, and the mean waist circumference was 40±6 cm. A total of 13 participants had a previous history of cardiovascular disease, 48 were diabetic, 88 were hypertensive, and 8 had other comorbidities. No statistically significant association was found between MetS and age or gender. However, MetS had a higher incidence among patients with diabetes (45 non-diabetics vs. 58 diabetics, p=0.003), hypertension (78 hypertensive vs. 25 non-hypertensive, p<0.001), obesity, and dyslipidemia. The waist circumference distribution was as follows: 17 patients with <90 cm, 60 with 91-114 cm, and 26 with >115 cm. Additionally, 78 patients had high triglycerides, 79 had low HDL, 52 had BMI in the overweight range, and 19 were categorized as obese. In-hospital outcomes, including mortality, length of hospital stay, readmissions, and complications, were not statistically significant. Atrial fibrillation occurred in 2 MetS patients vs. 1 non-MetS patient; STEMI was observed in 1 patient; VT in 3 patients; and failed thrombolysis in 1 non-MetS participant. Cardiogenic shock was noted in 1 patient. Conclusion: The prevalence of MetS among ACS patients in Pakistan is high. MetS was significantly associated with diabetes, hypertension, dyslipidemia, and obesity. However, it did not have a statistically significant impact on in-hospital outcomes when compared to patients without MetS.