Effect Of Metabolic Syndrome On Prognosis Of Acute ST-Segment Elevation Myocardial Infarction Patients Treated With Primary Percutaneous Coronary Intervention

Objective: To study the effect of metabolic syndrome(MS)on prognosis of acute ST-segment elevation myocardial infarction patients with primary percutaneous coronary intervention.Methods: This analysis included 964 patients admitted with acute STEMI undergoing primary PCI at the cardiovascular department in our hospital.The patients were divided into MS group(n=366)and non-MS group(n=598)according to the diagnostic criteria recommended by Chinese Diabetes Society.Clinical baseline characteristics,laboratory examination results,echocardiography result,coronary angiography results were recorded in hospital.Then the all-cause death events were recorded at 18-month follow-up between the two groups.SPSS23.0 software was used for data analysis.Measurement data conformed to normal distribution was registered as mean ± standard deviation,and independent sample t-test was used for comparison between groups.M(Q1,Q3)was used to describe the non-normal distribution and comparison between groups used the Kruskal-Wallis Test.Count datawas registered as composition ratio with chi-square test used in between groups.Survival rate in both groups was analyzed by Kaplan-Meier curve analysis.Survival rates were different between the two groups was used by Log-Rank test.The independ-ent risk factors for all cause mortality of acute STEMI were analyzed by binary logistic regression model.The test level was statistically significant at P < 0.05.Results: 1.A total of 964 patients were eligible for analysis,366 in the MS grou-p and 598 in the non-MS group.The prevalence of MS among acute STEMI patients treated with primary percutaneous coronary intervention was 37.97%.2.Patients in the MS group were more likely to have a history of hypertension and diabetes,with higher body weight and BMI,and the above differences were statistically significant(P < 0.05).With the increase of Killip grade,the proportion of MS group was higher than that of non-MS group(P < 0.05).Patients in the MS group had higher level of fasting blood-glucose,triglyceride,total cholesterol,low density lipoprotein cholesterin,Gamma-glutamyl transpeptidase,proalbumin,globulin,platelet distribution width,and lower high density lipoprotein cholesterol,glutamic oxalacetic transaminase,glutamic-pyruvic transaminase,serum chlorine as compared to the non-MS group after admission,and the above differences were statistically significant(P<0.05).3.MS group and non-MS group have significant differences in the number of(single vessel lesions(30.33% vs 41.64%),two vessel lesions(31.69% vs 35.95%),three vessel lesions(37.98% vs 22.74%)and collateral circulation(19.9% vs 14.5%)(P < 0.05).4.There were 56 all-cause deaths(5.8%)in the follow-up period of 18 months.The mortality of MS group was significantly higher than that of non-MS group(9.3% vs 3.7%,P < 0.001).5.Kaplan-meier survival curves were plotted for both MS and non-ms groups,logrank analysis revealed that the 18-month survival rate was significantly higher in MS group than in non-MS group(Log-Rank,P<0.001).6.The dependent variable was whether all-cause death occurred in the 18-month follow-up,Binary Logistic regression analysis showed that MS,age,Killip grade,prealbumin and white blood cell are independent risk factors for all-cause death in acute STEMI patients treated with PCI.Conclusion: 1.In patients with acute STEMI treated with PCI,patients with MS are more likely to form multi-vessel lesions.2.Acute STEMI patients with MS had a significantly lower 18-month survival rate than those without MS.3.MS,age,Killip grade,proalbumin,and white blood cell countwere independent risk factors for the all-cause mortality in acute STEMI patients undergoing PCI.