Rampengan, Starry H.
(2014)
METABOLIC SYNDROME PROFILE IN PATIENTS WITH STABLE
ISCHEMIC HEART DISEASE
AT JADE CARDIOVASCULAR CLINIC MANADO.
In: Simposium Konferensi Kerja Nasional PAPDI XID 2014.
Abstract
Background. Stable Ischemic Heart Disease is the leading cause of death in the whole world, despite the advent of multiple treatments that reduce mortality and morbidity. Metabolic syndrome is a risk factor for atherosclerosis with the key components are central adiposity, dyslipidemia (hypertriglyceridemia and low HDL cholesterol), hypertension and glucose intolerance, wether chronic inflammation, procoagulation , and impaired fibrinolysis are also thought to play a role. Early detection of metabolic syndrome with appropriate treatment could reduce morbidity and mortality.
Aim. The aim of the present study is to investigate the variables that could be use as a predictor of cardiovascular event in metabolic syndrome patients.
Methods. Two hundred stable ischemic heart disease patients with metabolic syndrome (mean age 58.87 ± 9.18 years) were enrolled in the study and candidate definitions of MS were proposed by modifying the NCEP ATP III definition for Asia Pacific region. These modifications included the following: waist circumference cutoffs as > 90 cm in men and >
80 cm in women, BMI cutoff as > 23 kg/m2. A follow up over one year was performed, with the end point of the study were acute coronary syndrome (ACS) event, heart failure,
cerebrovascular disease (CVD), renal dysfunction, peripheral arterial disease (PAD) and death.
Result. Most of the patients were in stage I of hypertension (JNC 8) and majority were treated with ACE Inhibitor and diet with regular exercise. Most of the diabetes mellitus (DM) patients receive oral hypoglycemic agent (55%), followed by diet and exercise (42%). Statin was used in most cases of dyslipidemia (71%). There were 81 cases of cardiovascular events which consist of ACS in 56 patients, CVD in 6 patients, heart failure in 8 patients, renal dysfunction in 10 patients and PAD in one patient. Inmetabolic syndrome patients that were having DM compared to those with no DM, the cardiovascular event rate increased from 6.5% to 34% (five fold increase), while in low HDL level patients compared to those with normal HDL level, the cardiovascular event rate was higher (28% vs 12.5%).
Conclusion. DM and low HDL level could be use as a prognostic indicator in Stable Ischemic Heart Disease patients with metabolic syndrome.
Keywords : metabolic syndrome, stable ischemic heart disease
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